FORM 1023-EZ for HELP4DIABETES

Field Data
EIN 83-0867238
Case Number EO-2018309-000511
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HELP4DIABETES
Organization’s Mailing Address 88 LA MIRAGE CIRCLE
City ALISO VIEJO
State CA
ZIP 92656-4226
Accounting period End 12
Primary contact name PATRICIA E SIMON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICIA E SIMON
PRESIDENT
88 LA MIRAGE CIRCLE
ALISO VIEJO CA 92656-4226

Officer/Director/Trustee Two

REGINA K JOHNSON
VICE PRESIDENT
88 LA MIRAGE CIRCLE
ALISO VIEJO CA 92656-4662

Officer/Director/Trustee Three

HEILE POTICAR
TREASURER
88 LA MIRAGE CIRCLE
ALISO VIEJO CA 92656-4226

Officer/Director/Trustee Four

WILLIAM ZIMMERER
CHAIRPERSON
88 LA MIRAGE CIRCLE
ALISO VIEJO CA 92656-4226

Officer/Director/Trustee Five

CHRISTINA MARTZ
SECRETARY
88 LA MIRAGE CIRCLE
ALISO VIEJO CA 92656-4226

Organization’s website HELP4DIABETES.ORG
Organization’s email PSIMON@HELP4DIABETES.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/9/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G12 - Fund Raising and/or Fund Distribution
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name PATRICIA E SIMON
Signature Title PRESIDENT
Signature Date 11/2/18

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