FORM 1023-EZ for BLACK LIONS MC PROGRAM INC

Field Data
EIN 85-3638645
Case Number EO-2020314-000172
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK LIONS MC PROGRAM INC
Organization’s Mailing Address 3061 NW 51ST STREET
City MIAMI
State FL
ZIP 33142
Accounting period End 12
Primary contact name FABIAN OWENS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

FABIAN OWENS
PRESIDENT
27496 SW 143RD CT
HOMESTEAD FL 33032

Officer/Director/Trustee Two

KERRY CHANDLER
VICE PRESIDENT
27496 SW 143RD CT
HOMESTEAD FL 33032

Officer/Director/Trustee Three

SONYA WILLIAMS
SECRETARY
11243 SW 11TH ST
PEMBROKE PINES FL 33025

Officer/Director/Trustee Four

KEANDRA HAYES
TREASURER
3061 NW 51ST ST
MIAMI FL 33142

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/16/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name FABIAN OWENS
Signature Title PRESIDENT
Signature Date 11/5/2020

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