FORM 1023-EZ for BROTHERS INSTITUTE FOR HEALTH EQUITY

Field Data
EIN 46-1519797
Case Number EO-2016040-000293
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BROTHERS INSTITUTE FOR HEALTH EQUITY
Organization’s Mailing Address 2517 S ARCHER AVE - GROUND FLOOR
City CHICAGO
State IL
ZIP 60608
Accounting period End 12
Primary contact name ARIQ CABBLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DAMON WARDLOW
CHAIR
5642 S CALUMET AVE
CHICAGO IL 60637

Officer/Director/Trustee Two

KEITH MAGEE
VICE CHAIR
SUITE 843 MC117-750 S HALSTED AVE
CHICAGO IL 60607

Officer/Director/Trustee Three

MARK LOVE
SECRETARY
5744 S INDIANA AVE
CHICAGO IL 60637

Officer/Director/Trustee Four

ARIQ CABBLER
EX-OFFICIO MEMBER
5642 S PRAIRIE AVE
CHICAGO IL 60637

Organization’s website N/A
Organization’s email CABBLER1104@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/5/2012
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 Yes
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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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