FORM 1023-EZ for CLEFT PREVENTION INTERNATIONAL FOUNDATION

Field Data
EIN 81-1007046
Case Number EO-2020177-000305
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CLEFT PREVENTION INTERNATIONAL FOUNDATION
Organization’s Mailing Address 1627 15TH AVENUE
City SAN FRANCISCO
State CA
ZIP 94122-3523
Accounting period End 12
Primary contact name MARIE TOLAROVA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARIE TOLAROVA
PRESIDENT AND DIRECTOR
1627 15TH AVENUE
SAN FRANCISCO CA 94122-3523

Officer/Director/Trustee Two

MIROSLAV TOLAR
VICE PRESIDENT AND DIRECTOR
1627 15TH AVENUE
SAN FRANCISCO CA 94122-3523

Officer/Director/Trustee Three

MICHAEL DEHAL
CHAIRMAN OF THE BOARD
1627 15TH AVENUE
SAN FRANCISCO CA 94122

Officer/Director/Trustee Four

AHMEND ABUMUSTAFA
TREASURER AND DIRECTOR
2380 LOWELL AVENUE
RICHMOND CA 94804

Officer/Director/Trustee Five

SHEETAL PATIL
SECRETARY AND DIRECTOR
335 RIO GRANDE PL
SAN RAMON CA 94800

Organization’s website
Organization’s email INFO@CLEFTPREVENTION.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/13/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G20 - Birth Defects and Genetic Diseases
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 MARIE TOLAROVA
Signature Title PRESIDENT AND DIRECTOR
Signature Date 6/16/2020

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