FORM 1023-EZ for LAKE COMMUNITY LIGHTED BEACON

Field Data
EIN 45-4038100
Case Number EO-2019273-000437
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LAKE COMMUNITY LIGHTED BEACON
Organization’s Mailing Address 1030 LA BONITA DRIVE SUITE 342
City SAN MARCOS
State CA
ZIP 92078-5291
Accounting period End 12
Primary contact name RICHARD MOOBERRY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GARY EDWARDS
PRESIDENT
1445 LA LOMA DRIVE
SAN MARCOS CA 92078-4737

Officer/Director/Trustee Two

PAM HERZOG
SECRETARY
921 LA FIESTA LANE
SAN MARCOS CA 92078-4737

Officer/Director/Trustee Three

RICHARD MOOBERRY
TREASURER
1468 LA LOMA DRIVE
SAN MARCOS CA 92078-4737

Officer/Director/Trustee Four

TWEET EDMONDS
MEMBER
1561 VIA ENTRADA DEL LAGO
SAN MARCOS CA 92078-4737

Officer/Director/Trustee Five

TONY GIRALAMO
MEMBER
1223 SAN JULIAN PLACE
SAN MARCOS CA 92078-4737

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/20/11
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
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 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 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 RICHARD MOOBERRY
Signature Title TREASURER
Signature Date 9/27/19

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