FORM 1023-EZ for AGING IN COMMUNITY - THREE RIVERS

Field Data
EIN 47-2155866
Case Number EO-2014364-000313
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AGING IN COMMUNITY - THREE RIVERS
Organization’s Mailing Address POST OFFICE BOX 896
City THREE RIVERS
State CA
ZIP 93271-0896
Accounting period End 12
Primary contact name SUSAN DARSEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARY ZLOTNICK
PRESIDENT
P O BOX 896
THREE RIVERS CA 93271-0896

Officer/Director/Trustee Two

SUSAN DARSEY
TREASURER
P O BOX 1016
THREE RIVERS CA 93271-1016

Officer/Director/Trustee Three

GRACE KLASSEN
VICE PRESIDENT
P O BOX 493
THREE RIVERS CA 93271-0493

Officer/Director/Trustee Four

MARILEE STEVENS
SECRETARY
P O BOX 897
THREE RIVERS CA 93271-0897

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/26/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P81 - Senior Centers, Services
Organization’s purpose Charitable: Yes
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 Yes
Donation of funds Yes
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
Signature Title
Signature Date

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