FORM 1023-EZ for NATIONAL BLACK MBA ASSOCIATION - SEATTLE CHAPTER

Field Data
EIN 46-5561592
Case Number EO-2015296-000282
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NATIONAL BLACK MBA ASSOCIATION - SEATTLE CHAPTER
Organization’s Mailing Address PO BOX 614
City BELLEVUE
State WA
ZIP 98009-0614
Accounting period End 8
Primary contact name THOMAS ROGERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

THOMAS ROGERS
DIRECTOR
6572 116TH PL NE
KIRKALND WA 98033-8447

Officer/Director/Trustee Two

KRAIG CARRERE
DIRECTOR
1530 DAVIS AVENUE SOUTH
RENTON WA 98005

Officer/Director/Trustee Three

KESHA HENDERSON
DIRECTOR
2700 NW PINE CONE DRIVE
ISSAQUAH WA 98027

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/5/2014
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J01 - 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 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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