FORM 1023-EZ for SIMPLY INSAN INC

Field Data
EIN 83-2117461
Case Number EO-2019115-000401
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SIMPLY INSAN INC
Organization’s Mailing Address 1531 JAMES STREET
City FAIRFIELD
State CA
ZIP 94533
Accounting period End 12
Primary contact name HASHIM HUSSEIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HASHIM HUSSEIN
PRESIDENT
1531 JAMES ST
FAIRFIELD CA 94533

Officer/Director/Trustee Two

FAIZAL MOHAMMED
TRUSTEE
1531 JAMES ST
FAIRFIELD CA 94533

Officer/Director/Trustee Three

IMRAN MOHAMMED
VICE PRESIDENT
1531 JAMES ST
FAIRFIELD CA 94533

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/20/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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 Yes
Correctness Declaration Yes
Signature Name HASHIM HUSSEIN
Signature Title PRESIDENT
Signature Date 4/23/19

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