FORM 1023-EZ for CRESCENT MOON THEATER PRODUCTIONS

Field Data
EIN 84-2549308
Case Number EO-2019296-000408
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CRESCENT MOON THEATER PRODUCTIONS
Organization’s Mailing Address 621 EUCALYPTUS WAY
City MILL VALLEY
State CA
ZIP 94941
Accounting period End 12
Primary contact name POLINA SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

POLINA SMITH
PRESIDENT
621 EUCALYPTUS WAY
MILL VALLEY CA 94941

Officer/Director/Trustee Two

ANNA SHUSTERMAN
TREASURER
53 BEVERLY RD
WEST HARTFORD CT 6119

Officer/Director/Trustee Three

AIDA CURTIS
CHAIRPERSON OF THE GOVERNING BODY
4506 WEST ST
OAKLAND CA 94608

Officer/Director/Trustee Four

FAINA SMITH
OFFICER
1313 WASHINGTON ST 601
BOSTON MA 2118

Officer/Director/Trustee Five

SAMSARA SHMEE
OFFICER
49 49TH ST
OAKLAND CA 94609

Organization’s website
Organization’s email POLINA@WHOLEBODYSF.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/15/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A60 - Performing Arts Organizations
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 No
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 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 POLINA SMITH
Signature Title PRESIDENT
Signature Date 10/21/19

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