FORM 1023-EZ for BACK TO THE BASICS COMMUNITY EMPOWERMENT ORGANIZATION

Field Data
EIN 82-4418309
Case Number EO-2019149-000128
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BACK TO THE BASICS COMMUNITY EMPOWERMENT ORGANIZATION
Organization’s Mailing Address 706 E 110TH STREET
City LOS ANGELES
State CA
ZIP 90059
Accounting period End 12
Primary contact name KELLI DILLON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLI DILLON
CEO
706 E 110TH STREET
LOS ANGELES CA 90059

Officer/Director/Trustee Two

KEISHA BERRY
SECRETARY
1128 W GARDENA BLVD
GARDENA CA 90247

Officer/Director/Trustee Three

KELLI DILLON
CFO
706 E 110TH STREET
LOS ANGELES CA 90059

Organization’s website
Organization’s email K.DILLON92@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/21/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 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 KELLI DILLON
Signature Title CFO
Signature Date 5/27/19

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