FORM 1023-EZ for ANACOSTIA MEDIA INSTITUTE

Field Data
EIN 82-4863304
Case Number EO-2018143-000238
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ANACOSTIA MEDIA INSTITUTE
Organization’s Mailing Address 2356 GREEN ST SE
City WASHINGTON
State DC
ZIP 20020
Accounting period End 12
Primary contact name MAX BLUMENTHAL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MAX BLUMENTHAL
PRESIDENT/TREASURER
2356 GREEN ST SE
WASHINGTON DC 20020

Officer/Director/Trustee Two

MARCELLA ABURDEEN
DIRECTOR
2356 GREEN ST SE
WASHINGTON DC 20020

Officer/Director/Trustee Three

EUGENE PURYEAR
DIRECTOR
2356 GREEN ST SE
WASHINGTON DC 20020

Officer/Director/Trustee Four

REBECCA CARROLL
DIRECTOR
6813 6TH ST NW
WASHINGTON DC 20012

Officer/Director/Trustee Five

ALI ABUNIMAH
SECRETARY
1507 E 53RD STREET 500
CHICAGO IL 60615

Organization’s website
Organization’s email MAXJBLUMENTHAL@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/5/18
Organization Incorporation State DC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
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 MAX BLUMENTHAL
Signature Title PRESIDENT/TREASURER
Signature Date 5/21/18

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