FORM 1023-EZ for DOV SYNERGY FOUNDATION

Field Data
EIN 83-0618910
Case Number EO-2018145-000761
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DOV SYNERGY FOUNDATION
Organization’s Mailing Address 23501 DOLOROSA ST STE 100A
City WOODLAND HILLS
State CA
ZIP 91367
Accounting period End 12
Primary contact name M DAVID COHEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

M DAVID COHEN
PRESIDENT/DIRECTOR
23501 DOLOROSA ST STE 100A
WOODLAND HILLS CA 91367

Officer/Director/Trustee Two

JACQUELINE GOLDBERG
TREASURER/SECRETARY /DIRECTOR
23501 DOLOROSA ST STE 100A
WOODLAND HILLS CA 91367

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/5/15
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P50 - Personal Social Services
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name M DAVID COHEN
Signature Title PRESIDENT/DIRECTOR
Signature Date 5/23/18

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