FORM 1023-EZ for PAY IT FORWARD HEALTHCARE EDUCATION
| Field | Data |
|---|---|
| EIN | 83-2468510 |
| Case Number | EO-2019045-000106 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | PAY IT FORWARD HEALTHCARE EDUCATION |
| Organization’s Mailing Address | 849 S BROADWAY APT M04 |
| City | LOS ANGELES |
| State | CA |
| ZIP | 90014-3218 |
| Accounting period End | 12 |
| Primary contact name | LAWRENCE A POLLISTER |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
LAWRENCE POLLISTER
PRESIDENT/CEO
849 S BROADWAY STE M04
LOS ANGELES CA 90014-3218
Officer/Director/Trustee Two
NICOLE YATES
VICE PRESIDENT
612 S FLOWER ST APT 801
LOS ANGELES CA 90017-2811
Officer/Director/Trustee Three
TINA ZHU
TREASURER/CFO
325 S ALMANSOR ST APT 27
ALHAMBRA CA 91801-4234
Officer/Director/Trustee Four
JULIANA STONE
SECRETARY/OFFICER
9 JOHNS CANYON RD
ROLLING HILLS CA 90274-5005
Officer/Director/Trustee Five
AZATUI VARPETYAN
OFFICER
3356 SILVER LAKE BLVD
LOS ANGELES CA 90039-2256
| Organization’s website | HTTP://WWW.PIFHE.ORG |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/30/18 |
| Organization Incorporation State | CA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | B82 - Scholarships, Student Financial Aid Services, Awards |
| 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 | 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 | LAWRENCE POLLISTER |
| Signature Title | PRESIDENT/CEO |
| Signature Date | 2/11/19 |
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