FORM 1023-EZ for SAN JOSE WATER POLO FOUNDATION INC

Field Data
EIN 47-5519256
Case Number EO-2016020-000055
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SAN JOSE WATER POLO FOUNDATION INC
Organization’s Mailing Address 316 51ST ST APT 4
City OAKLAND
State CA
ZIP 94609
Accounting period End 12
Primary contact name COLIN MELLO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ELIZABETH MELLO
CEO
316 51ST ST APT 4
OAKLAND CA 94609

Officer/Director/Trustee Two

PATRICK TALBOTT
SECRETARY/TREASURER
1961 FILBERT ST APT 305
SAN FRANCISCO CA 94123

Officer/Director/Trustee Three

CLARKE WEATHERSPOON
DIRECTOR
4451 MISSION ST APT 401
SAN FRANCISCO CA 94112

Officer/Director/Trustee Four

BRIAN DOMBROWSKI
DIRECTOR
1060 EMORY ST
SAN JOSE CA 95126

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/21/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N20 - Recreational and Sporting Camps
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
Signature Title
Signature Date

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