FORM 1023-EZ for VETTEDMED

Field Data
EIN 82-2544388
Case Number EO-2017299-000303
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name VETTEDMED
Organization’s Mailing Address 929 COLORADO AVENUE
City SANTA MONICA
State CA
ZIP 90401
Accounting period End 12
Primary contact name WILLIAM BERGSTROM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIAM BERGSTROM
PRESIDENT
929 COLORADO AVENUE
SANTA MONICA CA 90401

Officer/Director/Trustee Two

TISHA BERGSTROM
SECRETARY/TREASURER
929 COLORADO AVENUE
SANTA MONICA CA 90401

Officer/Director/Trustee Three

REZA JARRAHY
DIRECTOR
929 COLORADO AVENUE
SANTA MONICA CA 90401

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/26/2017
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: Yes
Religious: No
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 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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