FORM 1023-EZ for RECOVERY WORKS CAFE

Field Data
EIN 47-4806786
Case Number EO-2015243-000294
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RECOVERY WORKS CAFE
Organization’s Mailing Address 2685 PALA MESA
City COSTA MESA
State CA
ZIP 92627
Accounting period End 12
Primary contact name CHUMAHAN BOWEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

VELVET MANGAN
DIRECTOR
22372
HARWICH LN CA 92646

Officer/Director/Trustee Two

SALLY LAWRENCE
DIRECTOR
7706 HILLSIDE DR
LA JOLLA CA 92037

Officer/Director/Trustee Three

DEENA AVERY
DIRECTOR
6453 WEST 84TH PL
LOS ANGELES CA 90045

Officer/Director/Trustee Four

ALEX ZEMECKIS
DIRECTOR
1704 ALTA VISTA WAY
SAN DIEGO CA 92109

Officer/Director/Trustee Five

CONCETTA MARTINAN
DIRECTOR/CEO
PO BOX 7515 GIRARD AVE
LA JOLLA CA 92037

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/2/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F22 - Alcohol, Drug Abuse, Treatment Only
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 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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