FORM 1023-EZ for MS SENIOR CALIFORNIA OF AMERICA INC

Field Data
EIN 65-1200284
Case Number EO-2014275-000566
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MS SENIOR CALIFORNIA OF AMERICA INC
Organization’s Mailing Address 4417 BENHURST AVENUE
City SAN DIEGO
State CA
ZIP 95122
Accounting period End 12
Primary contact name PAMELA WHEELER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ELVIA HARRIS
CEO
4417 BENHURST AVENUE
SAN DIEGO CA 95122

Officer/Director/Trustee Two

PAMELA WHEELER
PRESIDENT
12 MACKENZIE LANE
COTO DE CAZA CA 92679

Officer/Director/Trustee Three

JUDY TALBOT
SECRETARY
4141 BRANFORD DRIVE
HUNTINGTON BEACH CA 92649

Officer/Director/Trustee Four

JAMIE CAPPELLI
DIRECTOR
2673 POLARIS WAY
LAVERNE CA 91750

Officer/Director/Trustee Five

JUDY BACKENCAMP
TREASURER
3595 SANTA FE 163
LONG BEACH CA 90810

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/16/2010
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A61 - Performing Arts Centers
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 Yes
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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