| Field | Data |
|---|---|
| EIN | 46-1461488 |
| Case Number | EO-2014232-000178 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | LAKE COUNTY YOUTH SERVICES |
| Organization’s Mailing Address | 4750 GOLF AVE |
| City | CLEARLAKE |
| State | CA |
| ZIP | 95422 |
| Accounting period End | 6 |
| Primary contact name | JOYCE OVERTON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
MICHAEL VANDIVER
PRESIDENT
3553 MAPLE STREET
CLEARLAKE CA 95422
BROCK FALKENBERG
VICE PRESIDENT
1919 TODD RD
LAKEPORT CA 95451
JACK SMALLEY
DIRECTOR
16710 FOX WAY
CLEARLAKE OAKS CA 95423
SAMANTHA SANDHOFF
DIRECTOR
13710 ARROWHEAD RD
CLEARLAKD CA 95422
PAULA MCGINNIS
SECRETARY
15238 HARBOR LN
CLEARLAKE CA 95422
| Organization’s website | CLEARLAKEYOUTHCENTER.ORG |
|---|---|
| Organization’s email | CLEARLAKEYOUTHCENTER@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 12/28/2012 |
| Organization Incorporation State | CA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | O20 - Youth Centers, Clubs, 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 | Yes |
| 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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