FORM 1023-EZ for ARKANSAS BLACK GAY MENS FORUM

Field Data
EIN 84-4309426
Case Number EO-2020104-000434
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ARKANSAS BLACK GAY MENS FORUM
Organization’s Mailing Address 11216 JOHNNA LANE LOT A
City JACKSONVILLE
State AR
ZIP 72076
Accounting period End 6
Primary contact name ANTOINE GHOSTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAMION SNOWDEN
SECRETARY
3200 COLEMAN PLACE APT 126
LITTLE ROCK AR 72204

Officer/Director/Trustee Two

A J AKBAR
TREASURER
3415 LEHIGH DRIVE
LITTLE ROCK AR 72204

Officer/Director/Trustee Three

ANTOINE GHOSTON
PRESIDENT
11216 JOHNNA LANE LOT A
JACKSONVILLE AR 72076

Officer/Director/Trustee Four

ANDRE ROWE
VICE PRESIDENT
9314 OAK GROVE LANE
LITTLE ROCK AR 72209

Officer/Director/Trustee Five

SHAYE ROWE
ASSISTANT SECRETARY
2525 OLD FARM RD APT 2126
HOUSTON TX 77063

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/5/2017
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code R20 - Civil Rights, Advocacy for Specific Groups
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 ANTOINE GHOSTON
Signature Title PRESIDENT
Signature Date 4/11/2020

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