FORM 1023-EZ for KINGS AGAINST VIOLENCE INITIATIVE INC

Field Data
EIN 81-1626947
Case Number EO-2016221-000010
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KINGS AGAINST VIOLENCE INITIATIVE INC
Organization’s Mailing Address 450 CLARKSON AVE MSC 1289
City BROOKLYN
State NY
ZIP 11203
Accounting period End 12
Primary contact name ROBERT GORE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JUDITH LA ROSA
DIRECTOR
450 CLARKSON AVE MS NO 43
BROOKLYN NY 11203

Officer/Director/Trustee Two

BENJAMIN SHULDINER
DIRECTOR
144 N 9TH STREET APT 3R
BROOKLYN NY 11249

Officer/Director/Trustee Three

REINALDO AUSTIN
DIRECTOR
451 CLARKSON AVE
BROOKLYN NY 11203

Organization’s website WWW.KAVIBROOKLYN.ORG
Organization’s email INFO@KAVIBROOKLYN.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/4/2013
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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