FORM 1023-EZ for VALLEY SOCIAL PRESCRIPTION

Field Data
EIN 86-2717574
Case Number EO-2021130-000199
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name VALLEY SOCIAL PRESCRIPTION
Organization’s Mailing Address 12406 E DEEP AVE
City CLOVIS
State CA
ZIP 93619
Accounting period End 12
Primary contact name CONNER MCKNIGHT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CONNER MCKNIGHT
PRESIDENT
12406 E DEEP AVE
CLOVIS CA 93619

Officer/Director/Trustee Two

JOHN PISH
SECRETARY
1096 W TWAIN AVE
FRESNO CA 93711

Officer/Director/Trustee Three

NAVKARAN GURM
CHIEF FINANCIAL OFFICER
14718 S WEST AVE
CARUTHERS CA 93609

Organization’s website VALLEYSOCIALPRESCRIPTION.ORG
Organization’s email CONTACT@VALLEYSOCIALPRESCRIPTION.ORG
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/23/2021
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F70 - Mental Health Disorders
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 CONNER MCKNIGHT
Signature Title PRESIDENT
Signature Date 5/6/2021

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