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2021-571-E-AMS-Chapel Hill-Carrboro Branch of the NAACP-Community climate grant project
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2021-571-E-AMS-Chapel Hill-Carrboro Branch of the NAACP-Community climate grant project
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Last modified
10/14/2021 1:48:29 PM
Creation date
10/14/2021 1:47:15 PM
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Template:
Contract
Date
10/7/2021
Contract Starting Date
10/7/2021
Contract Ending Date
10/14/2021
Contract Document Type
Agreement - Performance
Amount
$122,100.00
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OMB No. 1545-0047 <br />Department of the Treasury <br />Internal Revenue Service <br />Loan to or <br />from the <br />organization? <br />932131 10-21-19 <br />(Form 990 or 990-EZ)| Complete if the organization answered "Yes" on Form 990, Part IV, line 25a, 25b, 26, 27, 28a, <br />28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b. <br />Open To Public <br />Inspection <br />| Attach to Form 990 or Form 990-EZ. | Go to www.irs.gov/Form990 for instructions and the latest information. <br />Employer identification number <br />1 (b) (d) (a) (c) Yes No <br />2 <br />3 <br />(a) (c) (e) (g)(h) (i) (d) (b) (f) <br />Yes No Yes No Yes No <br />Total <br />(b) (a) (c) (d) (e) <br />For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.Schedule L (Form 990 or 990-EZ) 2019 <br />Approvedby board orcommittee? <br />Written <br />agreement? <br />Relationship <br />with organization <br />Name of the organization <br />(section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only). <br />Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b. <br />Relationship between disqualified <br />person and organization <br />Corrected?Name of disqualified person Description of transaction <br />Enter the amount of tax incurred by the organization managers or disqualified persons during the year under <br />section 4958 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~| <br />| <br />$ <br />$Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ~~~~~~~~~~~~~~~~ <br />Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a or Form 990, Part IV, line 26; or if the organization <br />reported an amount on Form 990, Part X, line 5, 6, or 22. <br />Name of <br />interested person <br />Purpose <br />of loan <br />Original <br />principal amount <br /> In <br />default? <br />Balance due <br />To From <br />|$ <br />Complete if the organization answered "Yes" on Form 990, Part IV, line 27. <br />Relationship between <br />interested person and <br />the organization <br />Name of interested person Amount of <br />assistance <br />Type of <br />assistance <br />Purpose of <br />assistance <br />LHA <br />SCHEDULE L <br />Part I Excess Benefit Transactions <br />Part II Loans to and/or From Interested Persons. <br />Part III Grants or Assistance Benefiting Interested Persons. <br />Transactions With Interested Persons <br />2019 <br />56-1955629 <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />30,000. <br />30,000. <br />30,000. <br />20,000. <br />10,000. <br />7,000. <br />0. <br />0. <br />0. <br />0. <br />0. <br />0. <br />BRANDON MOOREFI <br />LAUREN JOYCE <br />TODD JONES <br />RON COHN <br />JOHN SARGENT <br />LAUREN JOYCE <br />BOARD ME <br />REBUILDING TOGETHER OF THE TRIANGLE <br />SEE PART V FOR CONTINUATIONS <br />PROVIDE <br />BOARD ME PROVIDE <br />BOARD ME PROVIDE <br />BOARD ME PROVIDE <br />PARENTS PROVIDE <br />BOARD ME PROVIDE <br />DocuSign Envelope ID: 674071D6-B48A-4209-80A1-FCDFB6EDB134
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