FORM 1023-EZ for CONCRETE COLLECTIVE

Field Data
EIN 83-0630432
Case Number EO-2019028-000070
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CONCRETE COLLECTIVE
Organization’s Mailing Address 855 SCOTT STREET
City SAN FRANCISCO
State CA
ZIP 94117
Accounting period End 11
Primary contact name JAMAL BISHARAT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMAL BISHARAT
PRESIDENT
135 18TH AVENUE
SAN FRANCISCO CA 94121

Officer/Director/Trustee Two

VIRGINIA BISHARAT
TREASURER & SECRETARY
135 18TH AVENUE
SAN FRANCISCO CA 94121

Officer/Director/Trustee Three

WESLEY BELL
PRINCIPAL
423 20TH AVENUE APT 5
SAN FRANCISCO CA 94122

Officer/Director/Trustee Four

SHAWN CONNOLLY
EDUCATION DIRECTOR
834 HAIGHT STREET
SAN FRANCISCO CA 94117

Officer/Director/Trustee Five

JUSTIN MARKS
DONATIONS DIRECTOR
1300 26TH AVENUE APT 301
SAN FRANCISCO CA 94122

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/14/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 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 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 VIRGINIA BISHARAT
Signature Title TREASURER & SECRETARY
Signature Date 12/12/18

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