FORM 1023-EZ for CENTER FOR ACADEMIC AND SOCIAL ADVANCEMENT

Field Data
EIN 33-0878736
Case Number EO-2021081-000790
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CENTER FOR ACADEMIC AND SOCIAL ADVANCEMENT
Organization’s Mailing Address 4704 RAMSAY AVENUE
City SAN DIEGO
State CA
ZIP 92122
Accounting period End 12
Primary contact name JAN KOOISTRA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JIM BLEISNER
PRESIDENT
4106 MANZANITA DR
SAN DIEGO CA 92105

Officer/Director/Trustee Two

JAN KOOISTRA
SECRETARY
4676 RAMSAY AVE
SAN DIEGO CA 92122

Officer/Director/Trustee Three

LOURDES DURAN
CO-FOUNDER
1013 HOODER ST
ESCONDIDO CA 92027

Officer/Director/Trustee Four

LAURA SANTOS
BOARD MEMBER
1415 MINDEN DR
SAN DIEGO CA 92111

Officer/Director/Trustee Five

OLGA VASQUEZ
DIRECTOR EMERITA
4704 RAMSAY AVE
SAN DIEGO CA 92122

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/14/1999
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B90 - Educational Services and Schools - Other
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JAN KOOISTRA
Signature Title SECRETARY
Signature Date 1/26/2021

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