FORM 1023-EZ for KOREAN-AMERICAN DIABETES ASSOCIATION INC

Field Data
EIN 82-2192156
Case Number EO-2017257-000208
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KOREAN-AMERICAN DIABETES ASSOCIATION INC
Organization’s Mailing Address 2655 WEST OLYMPIC BLVD SUITE 207
City LOS ANGELES
State CA
ZIP 90006-2800
Accounting period End 12
Primary contact name KIRK S AN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALBERT AN
CEO/BOARD CHAIR
2655 WEST OLYMPIC BLVD SUITE 207
LOS ANGELES CA 90006-2800

Officer/Director/Trustee Two

ANA RIVERA
TREASURER/DIRECTOR
2655 WEST OLYMPIC BLVD SUITE 207
LOS ANGELES CA 90006-2800

Officer/Director/Trustee Three

LAURI AN
PRESIDENT
2655 WEST OLYMPIC BLVD SUITE 207
LOS ANGELES CA 90006-2800

Officer/Director/Trustee Four

KIRK AN
SECRETARY
2655 WEST OLYMPIC BLVD SUITE 207
LOS ANGELES CA 90006-2800

Officer/Director/Trustee Five

ANGIE LEE
DIRECTOR
2655 WEST OLYMPIC BLVD SUITE 207
LOS ANGELES CA 90006-2800

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/23/2017
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G80 - Specifically Named Diseases
Organization’s purpose Charitable: Yes
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 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 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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