FORM 1023-EZ for FAIR CHANCE FOR SPECIAL NEEDS

Field Data
EIN 81-1207523
Case Number EO-2016047-000247
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FAIR CHANCE FOR SPECIAL NEEDS
Organization’s Mailing Address 23 RAILROAD AVE/ SUITE 442
City DANVILLE
State CA
ZIP 94526
Accounting period End 12
Primary contact name DIANE MAZAROFF
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DIANE MAZAROFF
CHIEF OPERATING OFFICER
2600 JONES RD SUITE 13
WALNUT CREEK CA 94597

Officer/Director/Trustee Two

SHIRIN KAMAL
CHIEF EXECUTIVE OFFICER
512 WYCOMBE CT
SAN RAMON CA 94583

Organization’s website WWW.FAIRCHANCEFORSPECIALNEEDS.COM
Organization’s email INFO@FAIRCHANCEFORSPECIALNEEDS.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/29/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B28 - Specialized Education Institutions
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 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
Signature Title
Signature Date

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