FORM 1023-EZ for AUTISM BEHAVIORAL CENTER ADULT DAYCARE

Field Data
EIN 81-2849036
Case Number EO-2016160-000251
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AUTISM BEHAVIORAL CENTER ADULT DAYCARE
Organization’s Mailing Address 1901 W 66TH STREET
City LOS ANGELES
State CA
ZIP 90047
Accounting period End 12
Primary contact name GWEN SCOTT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MICHAEL WOODSON
PRESIDENT
5743 S HARCOURT
LOS ANGELES CA 90043

Officer/Director/Trustee Two

AMBROSHA ADKINS
SECRETARY
17906 CLARK AVE UNIT 5
BELLFLOWER CA 90706

Officer/Director/Trustee Three

DYMOND FARROR
TREASURER
1901 W 66TH STREET
LOS ANGELES CA 90047

Organization’s website
Organization’s email IBLEVN3@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/19/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
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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