FORM 1023-EZ for BLACK-AMERICAN COMMUNITY OUTREACH

Field Data
EIN 85-1845575
Case Number EO-2020237-000174
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK-AMERICAN COMMUNITY OUTREACH
Organization’s Mailing Address 1036 HIGH AVE
City SHEBOYGAN
State WI
ZIP 53081
Accounting period End 12
Primary contact name JAN MAULDIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL THOMAS
PRESIDENT/EXECUTIVE DIRECTOR
1036 HIGH AVE
SHEBOYGAN WI 53081

Officer/Director/Trustee Two

COREY ROBINSON
VICE PRESIDENT
2418 N36TH STREET
SHEBOYGAN WI 53083

Officer/Director/Trustee Three

PENNY ROGERS
TREASURE
1319 NEW JERSEY AVE
SHEBOYGAN WI 53081

Officer/Director/Trustee Four

CRISTOPHER JACKSON
SECRETARY
6-F208 4118 OAKDALE COURT
SHEBOYGAN WI 53081

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/2020
Organization Incorporation State WI
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: Yes
Educational: Yes
Scientific: Yes
Literary: Yes
Public Safety: Yes
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
Unrelated Gross Income $1,000 or More Yes
Gaming Activity No
Disaster relief assistance Yes
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MICHAEL THOMAS
Signature Title PRESIDENT/EXECUTIVE DIRECTOR
Signature Date 8/20/2020

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