FORM 1023-EZ for ST JOSEPH VALLEY COMMUNITY AND YOUTH ADVOCACY ASSOCIATION INC

Field Data
EIN 81-2946183
Case Number EO-2016174-000085
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ST JOSEPH VALLEY COMMUNITY AND YOUTH ADVOCACY ASSOCIATION INC
Organization’s Mailing Address 3609 ADDISON ST
City SOUTH BEND
State IN
ZIP 46614
Accounting period End 6
Primary contact name SHEMIKA HARRIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RAY BARHAM
PRESIDENT
3609 ADDISON
SOUTH BEND IN 46614

Officer/Director/Trustee Two

STEVE NKOSI
CHAIRMAN
540 UNIVERSITY PARK CT
MISHAWAKA IN 46545

Officer/Director/Trustee Three

OTIS HACKETT
SECRETARY
2718 PRAIRE ST
ELKHART IN 46517

Officer/Director/Trustee Four

MYLES BOLDEN
BOARD MEMBER
2007 NORTHSIDE BLVD
SOUTH BEND IN 46615

Officer/Director/Trustee Five

MALISSA WHITE
BOARD MEMBER
5221 W WASHINGTON ST
SOUTH BEND IN 46619

Organization’s website HTTP://WWW.MICHIANAHUB.ORG/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/22/2015
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
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
Signature Title
Signature Date

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