FORM 1023-EZ for THE MOMBAE MOVEMENT INC

Field Data
EIN 86-2873092
Case Number EO-2021133-000170
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE MOMBAE MOVEMENT INC
Organization’s Mailing Address 4389 SAHARA DR NW
City KENNESAW
State GA
ZIP 30144
Accounting period End 12
Primary contact name OLLISIA CYRUS BENGALL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

OLLISIA BENGALL
EXECUTIVE DIRECTOR
4389 SAHARA DR NW
KENNESAW GA 30144

Officer/Director/Trustee Two

SHAHLA BABAEVA
OFFICER
1227 OLDE LEGACY LANE
MABLETON GA 30126

Officer/Director/Trustee Three

LOREN WILLIAMS
TREASURER
3403 SOUTHSIDE COVE CT
JONESBORO GA 30236

Organization’s website WWW.MOMBAEINC.ORG
Organization’s email LEESEY@MOMBAEINC.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/5/2021
Organization Incorporation State GA
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: 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 OLLISIA BENGALL
Signature Title EXECUTIVE DIRECTOR
Signature Date 5/12/2021

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