FORM 1023-EZ for BLACK ENVIRONMENTAL LEADERS ASSOCIATION

Field Data
EIN 85-2819234
Case Number EO-2020265-000717
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK ENVIRONMENTAL LEADERS ASSOCIATION
Organization’s Mailing Address 34194 AURORA RD NUM 236
City SOLON
State OH
ZIP 44139
Accounting period End 12
Primary contact name SEMIA BRAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACQUELINE GILLON
CO-FACILITATOR
15560 HENLEY RD
EAST CLEVELAND OH 44112

Officer/Director/Trustee Two

DAVID WILSON
CO-FACILITATOR
4111 LEONA DRIVE
ROCKY RIVER OH 44116

Officer/Director/Trustee Three

SEMIA BRAY
CO-FACILITATOR
6100 RICHMOND ROAD
OAKWOOD VILLAGE OH 44146

Organization’s website WWW.BE-LEADERS.ORG
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/3/2020
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C03 - Professional Societies, Associations
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 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 SEMIA BRAY
Signature Title CO-FACILITATOR
Signature Date 9/19/2020

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