FORM 1023-EZ for PEACE ISLANDS INSTITUTE PENNSYLVANIA

Field Data
EIN 84-5028045
Case Number EO-2020199-000111
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PEACE ISLANDS INSTITUTE PENNSYLVANIA
Organization’s Mailing Address 1650 MARKET ST SUITE 3600 - 00138
City PHILADELPHIA
State PA
ZIP 19103
Accounting period End 12
Primary contact name MUHAMMED SAID SELMANLAR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LOWELL GUSTAFSON
PRESIDENT
116 FAIRFAX ROAD
BRYN MAWR PA 19010

Officer/Director/Trustee Two

ROCHELLE ROBBINS
TREASURER
9801 FRANKFORD AVE
PHILADELPHIA PA 19114

Officer/Director/Trustee Three

RASHID GABBASOV
SECRETARY
7930 BARNES ST APT B8
PHILADELPHIA PA 19111

Officer/Director/Trustee Four

DONNA L MAREE
BOARD MEMBER
2212 SPRUCE ST
PHILADELPHIA PA 19103

Officer/Director/Trustee Five

SULEYMAN ERDEM
BOARD MEMBER
501 CURTIS CT
CHESTERBROOK PA 19087

Organization’s website WWW.PEACEISLANDSPA.ORG
Organization’s email CONTACT@PEACEISLANDSPA.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/6/2020
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S99 - Community Improvement, Capacity Building N.E.C.
Organization’s purpose Charitable: Yes
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 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 LOWELL GUSTAFSON
Signature Title PRESIDENT
Signature Date 7/15/2020

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