FORM 1023-EZ for CHIROPRACTIC FOR VIETNAM

Field Data
EIN 81-3993764
Case Number EO-2017025-000063
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHIROPRACTIC FOR VIETNAM
Organization’s Mailing Address 7687 WESTMINSTER BOULEVARD
City WESTMINSTER
State CA
ZIP 92683-3921
Accounting period End 12
Primary contact name KHOA LE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KHOA LE
DIRECTOR AND PRESIDENT/CEO
2889 PEPPERTREE WAY
POMONA CA 91767-1952

Officer/Director/Trustee Two

PHUONG PHAM
DIRECTOR AND SECRETARY
15123 BROOKHURST STREET APARTMENT 4
WESTMINSTER CA 92683-6066

Officer/Director/Trustee Three

NAM NGUYEN
DIRECTOR AND TREASURER
12172 9TH STREET
GARDEN GROVE CA 92840-3533

Organization’s website NONE
Organization’s email CHIRO4VN@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/9/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E30 - Health Treatment Facilities, Primarily Outpatient
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 Yes
Donation of funds No
Conducting Activities Outside of United States Yes
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
Signature Title
Signature Date

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