FORM 1023-EZ for SUSTAINABILITY AND COMMUNITY HEALTH INITIATIVE

Field Data
EIN 85-3559522
Case Number EO-2021053-000177
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SUSTAINABILITY AND COMMUNITY HEALTH INITIATIVE
Organization’s Mailing Address 770 BLANCHARD WAY
City SUNNYVALE
State CA
ZIP 94087
Accounting period End 12
Primary contact name AMY LAWRENCE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANGELA SHIELDS
DIRECTOR AND PRESIDENT
770 BLANCHARD WAY
SUNNYVALE CA 94087

Officer/Director/Trustee Two

MICHELLE NICOLET
DIRECTOR AND TREASURER
19 IRVING AVENUE
ATHERTON CA 94027

Officer/Director/Trustee Three

SEAN CLANCY
DIRECTOR AND SECRETARY
4208 TERRACE STREET
OAKLAND CA 94611

Organization’s website HTTPS://WWW.KIDSINNUTRITION.ORG/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/8/2020
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K40 - Nutrition Programs
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 No
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 ANGELA SHIELDS
Signature Title DIRECTOR AND PRESIDENT
Signature Date 12/23/2020

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