FORM 1023-EZ for SIB4SIB INC

Field Data
EIN 82-5210398
Case Number EO-2018110-000199
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SIB4SIB INC
Organization’s Mailing Address 29757 DEER RUN
City FARMINGTON HILLS
State MI
ZIP 48331-1979
Accounting period End 12
Primary contact name JESSICA GOLDBERG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESSICA GOLDBERG
PRESIDENT
29757 DEER RUN
FARMINGTON HILLS MI 48331-1979

Officer/Director/Trustee Two

SAMANTHA SHAPIRO
TREASURER
26715 HUMBER
HUNTINGTON WOORS MI 48070-1260

Officer/Director/Trustee Three

BETTY CHU
BOARD MEMBER
233 WARRINGTON ROAD
BLOOMFIELD HILLS MI 48304-2952

Organization’s website
Organization’s email
Organization Incorporated
Organization trust Yes
Necessary Organizing Documents Yes
Organization Incorporation Date 4/11/18
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F80 - Mental Health Association, Multipurpose
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 Yes
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 JESSICA GOLDBERG
Signature Title PRESIDENT
Signature Date 4/18/18

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