FORM 1023-EZ for ETOMBI FOUNDATION
| Field | Data |
|---|---|
| EIN | 86-1591943 |
| Case Number | EO-2021078-001211 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | ETOMBI FOUNDATION |
| Organization’s Mailing Address | 9900 WESTPARK DR STE 328 |
| City | HOUSTON |
| State | TX |
| ZIP | 77063 |
| Accounting period End | 12 |
| Primary contact name | NAOMI MOUSSA |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
NAOMI MOUSSA
PRESIDENT
35 N ORCHARD AVE
WAUKEGAN IL 60085
Officer/Director/Trustee Two
IRENE ANDERSON
DIRECTOR
5909 ARBOR GATE DR
PLAINFIELD IL 60586
Officer/Director/Trustee Three
PRISCILLA MOUSSA
DIRECTOR
114 WASHINGTON TERRACE
WAUKEGAN IL 60085
Officer/Director/Trustee Four
DZEKEM BONAVENTURE
DIRECTOR
4125 SOUTH VINCENNES AVENUE
CHICAGO IL 60653
Officer/Director/Trustee Five
RENE AKOKO
DIRECTOR
654 BARBADOS DR APT 6
INDIANAPOLIS IN 46227
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/18/2021 |
| Organization Incorporation State | TX |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P99 - Human Services - Multipurpose and Other N.E.C. |
| 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 | Yes |
| 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 | NAOMI MOUSSA |
| Signature Title | PRESIDENT |
| Signature Date | 1/22/2021 |
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