FORM 1023-EZ for DIABLO VALLEY ARTS ACADEMY

Field Data
EIN 47-5045872
Case Number EO-2015341-000437
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DIABLO VALLEY ARTS ACADEMY
Organization’s Mailing Address 1601 N MAIN STREET SUITE 106
City WALNUT CREEK
State CA
ZIP 94596
Accounting period End 12
Primary contact name JESSICA SIEGEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JESSICA SIEGEL
EXECUTIVE DIRECTOR
1601 N MAIN STREET SUITE 10
WALNUT CREEK CA 94596

Officer/Director/Trustee Two

DESTINY MUHAMMAD
PRESIDENT
1601 N MAIN ST SUITE 106
WALNUT CREEK CA 94596

Officer/Director/Trustee Three

MELINDA CHINN
SECRETARY
1601 N MAIN ST SUITE 106
WALNUT CREEK CA 94596

Officer/Director/Trustee Four

JANICE TAYLOR
TREASURER
1601 N MAIN ST SUITE 106
WALNUT CREEK CA 94596

Officer/Director/Trustee Five

LORRAINE SUMULONG
VICE PRESIDENT
1601 N MAIN ST SUITE 106
WALNUT CREEK CA 94596

Organization’s website HTTP://WWWDIABLOVALLEYARTS,ORG
Organization’s email DVAA@PACBELL.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/2/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A25 - Arts Education
Organization’s purpose Charitable: No
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 Yes
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 Yes
One Third Support Gifts No
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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