FORM 1023-EZ for CHI EPSILON-079 SAN JOSE STATE UNIVERSITY

Field Data
EIN 23-7230858
Case Number EO-2017125-000145
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHI EPSILON-079 SAN JOSE STATE UNIVERSITY
Organization’s Mailing Address BOX 19316
City ARLINGTON
State TX
ZIP 76019-0316
Accounting period End 12
Primary contact name GLENN C GOSS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIERSTEN MILLER
PRESIDENT
101 EAST SAN FERNANDO APT 545
SAN JOSE CA 95112-7425

Officer/Director/Trustee Two

WILLIAM LANDRETH
VICE PRESIDENT
576 GIUFFRIDA AVE
SAN JOSE CA 95123

Officer/Director/Trustee Three

IVO MISKIC
SECRETARY
545 NEWVILLE DRIVE
LOS GATOS CA 95032-1140

Officer/Director/Trustee Four

IVOR JOHN MAASIN
TREASURER
2501 RALEIGH COURT
FAIRFIELD CA 94533-6710

Officer/Director/Trustee Five

GLENN GOSS
EXECUTIVE SECRETARY
BOX 19316
ARLINGTON TX 76019-0316

Organization’s website
Organization’s email XEHQ@CHI-EPSILON.ORG
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/21/1971
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B03 - Professional Societies, Associations
Organization’s purpose Charitable: No
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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