FORM 1023-EZ for LEESVILLE PACIFIC

Field Data
EIN 36-4888079
Case Number EO-2018064-000458
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LEESVILLE PACIFIC
Organization’s Mailing Address 8791 HEATHERMIST WAY
City ELK GROVE
State CA
ZIP 95624
Accounting period End 12
Primary contact name STEPHEN J GREENE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GRAHAM SARGENT
PRESIDENT
8791 HEATHERMIST WAY
ELK GROVE CA 95624

Officer/Director/Trustee Two

TOMMY HOPKINS
TREASURER
1849 C 7TH ST
OLIVEHURST CA 95961

Officer/Director/Trustee Three

LORI STONE
SECRETARY
5548 WATERHOLE LOOP
MARYSVILLE CA 95901

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/23/17
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 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 GRAHAM SARGENT
Signature Title PRESIDENT
Signature Date 3/2/18

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