FORM 1023-EZ for SOUTH SUDAN COMMUNITY SERVICES USA

Field Data
EIN 84-2656123
Case Number EO-2021100-000357
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUTH SUDAN COMMUNITY SERVICES USA
Organization’s Mailing Address 11306 BIRCH PLAZA APT 11
City OMAHA
State NE
ZIP 68164
Accounting period End 12
Primary contact name BOTH REAT Y LUAK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BOTH REAT LUAK
FOUNDER/CEO
11306 BIRCH PLAZA APT 11
OMAHA NE 68164

Officer/Director/Trustee Two

NYAKUME RIEK
FINANCE OFFICER
11306 BIRCH PLAZA APT 11
OMAHA NE 68164

Officer/Director/Trustee Three

NYUON TENY
SECRETARY
5101 TERES DR
OMAHA NE 68134

Officer/Director/Trustee Four

MACHAR MAMER
VICE PRESIDENT
2539 NORTH 18TH ST
OMAHA NE 68110

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/28/2019
Organization Incorporation State NE
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: Yes
Scientific: No
Literary: Yes
Public Safety: No
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 Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
Gaming Activity No
Disaster relief assistance Yes
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 BOTH REAT LUAK
Signature Title FOUNDER/CEO
Signature Date 3/24/2021

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