FORM 1023-EZ for CA YOUTH WARRIORS BASKETBALL INC

Field Data
EIN 82-5392370
Case Number EO-2018135-000042
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CA YOUTH WARRIORS BASKETBALL INC
Organization’s Mailing Address 969 G EDGEWATER BLVD STE 183
City FOSTER CITY
State CA
ZIP 94404
Accounting period End 3
Primary contact name MATTHEW TILLMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MATTHEW TILLMAN
PRESIDENT, DIRECTOR
969 G EDGEWATER BLVD STE 183
FOSTER CITY CA 94404

Officer/Director/Trustee Two

DOUGLAS DEWITT
SECRETARY, DIRECTOR
477 E HILLSDALE BLVD
SAN MATEO CA 94403

Officer/Director/Trustee Three

WAYNE RAM
TREASURER, DIRECTOR
1136 TANGLE WOOD WAY
SAN MATEO CA 94403

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/16/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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 MATTHEW TILLMAN
Signature Title PRESIDENT, DIRECTOR
Signature Date 5/9/18

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