FORM 1023-EZ for 100 BLACK MEN OF AMERICA OF SELMA INC

Field Data
EIN 81-3764298
Case Number EO-2016307-000199
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name 100 BLACK MEN OF AMERICA OF SELMA INC
Organization’s Mailing Address 1600 BROAD STREET
City SELMA
State AL
ZIP 36701
Accounting period End 12
Primary contact name DARYL D THOMAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WARREN YOUNG
PRESIDENT
1720 LAWRENCE STREET
SELMA AL 36703

Officer/Director/Trustee Two

DARYL THOMAS
TREASURER
419 BIRCH AVENUE
SELMA AL 36701

Officer/Director/Trustee Three

CHARLES JOHNSON SR
BOARD MEMBER
2006 SECOND AVENUE
SELMA AL 36703

Officer/Director/Trustee Four

BRIAN GOSA
BOARD MEMBER
213 OLD MARION JUNCTION ROAD
SELMA AL 36701

Officer/Director/Trustee Five

KENYOTTA RUCKER
BOARD MEMBER
2714 EAST CASTLEWOOD DRIVE
SELMA AL 36701

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/7/2016
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O30 - Adult, Child Matching Programs
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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
Signature Title
Signature Date

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