FORM 1023-EZ for JAN MEDA

Field Data
EIN 82-4674094
Case Number EO-2018107-000763
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JAN MEDA
Organization’s Mailing Address 19553 QUINTON OAKS LANE
City LEESBURG
State VA
ZIP 20175-7203
Accounting period End 12
Primary contact name THEODROS FEKADE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THEODROS FEKADE
DIRECTOR
19553 QUINTON OAKS LANE
LEESBURG VA 20175-7203

Officer/Director/Trustee Two

ROBEL DESTA
DIRECTOR
11215 OAK LEAF DRIVE UNIT 303
SILVER SPRING MD 20901

Officer/Director/Trustee Three

MUBARAK MOHAMED
DIRECTOR
1131 UNIVERSITY BLVD W UNIT 1219
SILVER SPRING MD 20902

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/19/18
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
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 THEODROS FEKADE
Signature Title DIRECTOR
Signature Date 3/29/18

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