FORM 1023-EZ for BLACK SMALL BUSINESS ASSOCIATION OFCALIFORNIA

Field Data
EIN 90-1680701
Case Number EO-2021242-000138
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK SMALL BUSINESS ASSOCIATION OFCALIFORNIA
Organization’s Mailing Address 9355 E STOCKTON BLVD SUITE 217
City ELK GROVE
State CA
ZIP 95758
Accounting period End 12
Primary contact name JOHN BLACK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SALENA PRYOR
DIRECTOR
9355 E STOCKTON BLVD SUITE 217
ELK GROVE CA 95758

Officer/Director/Trustee Two

CAROLYN VEAL HUNTER
DIRECTOR
8860 DUTRA BEND WAY
SACRAMENTO CA 95731

Officer/Director/Trustee Three

KAY POWELL
DIRECTOR
10010 DONA NEELY WAY
ELK GROVE CA 95758

Officer/Director/Trustee Four

CARL WASHINGTON
DIRECTOR
7920 PARMELEE AVENUE
LOS ANGELES CA 90001

Organization’s website WWW.BSBA-CA.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/24/2021
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S43 - Management Services for Small Business, Entrepreneurs
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 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 SALENA PRYOR
Signature Title DIRECTOR
Signature Date 8/27/2021

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