FORM 1023-EZ for BLACK BOYS LEADERSHIP ALLIANCE FORCHANGE B-BLAC INC

Field Data
EIN 85-2215725
Case Number EO-2020246-000430
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK BOYS LEADERSHIP ALLIANCE FORCHANGE B-BLAC INC
Organization’s Mailing Address 80-40 LEFFERTS BLVD APT 6B
City KEW GARDENS
State NY
ZIP 11415-1704
Accounting period End 12
Primary contact name JEVONE ANDY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEVONE ANDY
PRESIDENT AND CO-FOUNDER
80-40 LEFFERTS BLVD APT 6B
KEW GARDENS NY 11415-1704

Officer/Director/Trustee Two

ANDREW CLARKE
CO-FOUNDER AND DIRECTOR
118-05 200TH STREET
ST. ALBANS NY 11412-3522

Officer/Director/Trustee Three

NYENDA CAMMOCK
SECRETARY
950 RUTLAND ROAD APT 727
BROOKLYN NY 11212-1518

Officer/Director/Trustee Four

JOVAUN BLACK
TREASURER
948 RALPH AVENUE
BROOKLYN NY 11236-1053

Officer/Director/Trustee Five

SHAUN MAPP
DIRECTOR
786 MILLER AVENUE
BROOKLYN NY 11207-7416

Organization’s website NONE
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/31/2020
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 Yes
Donation of funds No
Conducting Activities Outside of United States Yes
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 JEVONE ANDY
Signature Title PRESIDENT AND CO-FOUNDER
Signature Date 8/31/2020

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