FORM 1023-EZ for SHALOM ISRAEL AMERICA

Field Data
EIN 86-1445217
Case Number EO-2021091-000760
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHALOM ISRAEL AMERICA
Organization’s Mailing Address 1204 1/2 LYNDON ST
City SOUTH PASADENA
State CA
ZIP 91030
Accounting period End 12
Primary contact name HANNA LEE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GYUNG SUK CHOI
PRESIDENT
1204 1/2 LYNDON ST
SOUTH PASADENA CA 91030

Officer/Director/Trustee Two

HANNA MOON LEE
TREASURER
14605 TUNDRA DR
SYLMAR CA 91342

Officer/Director/Trustee Three

JUNGMIN LEE
SECRETARY
8692 9TH ST UNIT 62
RANCHO CUCAMONGA CA 91730

Officer/Director/Trustee Four

LYDIA KIM
VICE PRESIDENT
235 S OCCIDENTAL BLVD
LOS ANGELES CA 90057

Officer/Director/Trustee Five

HAK SUN PARK
DIRECTOR
16445 DERIAN AVE
IRVINE CA 92614

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/26/2020
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X99 - Religion Related, Spiritual Development N.E.C.
Organization’s purpose Charitable: No
Religious: Yes
Educational: Yes
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 Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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 HANNA MOON LEE
Signature Title TREASURER
Signature Date 2/22/2021

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