FORM 1023-EZ for JAZZINDARY MUSIC FOUNDATION

Field Data
EIN 80-0824608
Case Number EO-2015282-000376
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JAZZINDARY MUSIC FOUNDATION
Organization’s Mailing Address 4029 DUPONT AVENUE N APT 1
City MINNEAPOLIS
State MN
ZIP 55412-1612
Accounting period End 12
Primary contact name NIEMA BROADNAX
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NIEMA BROADNAX
DIRETOR AND PRESIDENT/CEO
4029 DUPONT AVENUE N APT 2
MINNEAPOLIS MN 55412-1612

Officer/Director/Trustee Two

ANDRE BROADNAX
TRESURER/CFO
6941 DOUGLAS DRIVE N
BROOKLYN PARK MN 55429-1038

Officer/Director/Trustee Three

JAMES SAMUEL HARRIS
BOARD DIRECTOR
810 IRVING AVENUE N
MINNEAPOLIS MN 55411-3959

Officer/Director/Trustee Four

RIANA WILLIAMS
BOARD MEMBER
3629 LOGAN AVENUE N
MINNEAPOLIS MN 55412-1949

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/7/2012
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A68 - Music
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date
EIN 80-0824608
Case Number EO-2014324-000235
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JAZZINDARY MUSIC FOUNDATION
Organization’s Mailing Address 4029 DUPONT AVENUE N APT 1
City MINNEAPOLIS
State MN
ZIP 55412-1612
Accounting period End 12
Primary contact name NIEMA BROADNAX
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NIEMA BROADNAX
DIRECTOR AND PRESIDENT/CEO
4029 DUPONT AVENUE N APT 2
MINNEAPOLIS MN 55412-1612

Officer/Director/Trustee Two

ANDRE BROADNAX
TREASURER/CFO
6941 DOUGLAS DRIVE N
BROOKLYN PARK MN 55429-1038

Officer/Director/Trustee Three

TOM WHITE
SECRETARY
4029 DUPONT AVENUE N
MINNEAPOLIS MN 55412-1612

Officer/Director/Trustee Four

JAMES SAMUEL HARRIS
DIRECTOR
810 IRVING AVENUE N
MINNEAPOLIS MN 55411-3959

Officer/Director/Trustee Five

RIANA WILLIAMS
DIRECTOR
3629 LOGAN AVENUE N
MINNEAPOLIS MN 55412-1949

Organization’s website WWW.JAZZINDARYMUSIC.COM
Organization’s email JAZZINDARYMUSICFOUNDATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/7/2012
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A68 - Music
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 Yes
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
Signature Title
Signature Date

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