FORM 1023-EZ for NEW YORK BLACK LIVES MATTER INC

Field Data
EIN 81-4720980
Case Number EO-2016362-000414
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NEW YORK BLACK LIVES MATTER INC
Organization’s Mailing Address C/O NEWSOME - 955 SHERIDAN AVE 5B
City BRONX
State NY
ZIP 10456-6316
Accounting period End 12
Primary contact name ARTHUR SCHWARTZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WALTER NEWSOME JR
OFFICER
955 SHERIDAN AVE 5B
BRONX NY 10456-6316

Officer/Director/Trustee Two

CHIVONA NEWSOME
OFFICER
955 SHERIDAN AVE 5B
BRONX NY 10456-6316

Officer/Director/Trustee Three

EMANUELLA MATHURIN
OFFICER
3013 VALENTINE AVE 3E
BRONX NY 10458-1613

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/22/2016
Organization Incorporation State NY
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: 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 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 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
Signature Title
Signature Date

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