FORM 1023-EZ for SUITCASE CLINIC COMMUNITY

Field Data
EIN 47-5664137
Case Number EO-2017328-000329
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SUITCASE CLINIC COMMUNITY
Organization’s Mailing Address PO BOX 25240
City SAN MATEO
State CA
ZIP 94402-5240
Accounting period End 6
Primary contact name ROBERT K SHITAMOTO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT SHITAMOTO
INITIAL DIRECTOR, PRES, SEC, TREAS
PO BOX 25240
SAN MATEO CA 94402-5240

Organization’s website
Organization’s email SUITCASECCOMMUNITY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/17/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P85 - Homeless Persons 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 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
Signature Title
Signature Date

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