FORM 1023-EZ for INTERNATIONAL SUPPORT FIBROMYALGIA NETWORK

Field Data
EIN 81-4591862
Case Number EO-2017041-000276
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name INTERNATIONAL SUPPORT FIBROMYALGIA NETWORK
Organization’s Mailing Address 80 W SIERRA MADRE BLVD 104
City SIERRA MADRE
State CA
ZIP 91024-1718
Accounting period End 12
Primary contact name MELISSA TALWAR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MELISSA TALWAR
PRESIDENT
80 W SIERRA MADRE BLVD 104
SIERRA MADRE CA 91024-1718

Officer/Director/Trustee Two

MICHAEL MONDRAGON
CHIEF FINANCIAL OFFICER
80 W SIERRA MADRE BLVD 104
SIERRA MADRE CA 91024-1718

Officer/Director/Trustee Three

CYRENE JAGGER
SECRETARY
80 W SIERRA MADRE BLVD 104
SIERRA MADRE CA 91024-1718

Officer/Director/Trustee Four

NORMAN HANLEY
DIRECTOR
80 W SIERRA MADRE BLVD 104
SIERRA MADRE CA 91024-1718

Officer/Director/Trustee Five

BRANDI CLEVINGER
DIRECTOR
80 W SIERRA MADRE BLVD 104
SIERRA MADRE CA 91024-1718

Organization’s website SUPPORTFIBROMYALGIA.ORG
Organization’s email MELISSA@SUPPORTFIBRO.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/8/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G01 - Alliance/Advocacy Organizations
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 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
Signature Title
Signature Date

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