FORM 1023-EZ for MEDICARE SMART INC

Field Data
EIN 83-3845161
Case Number EO-2019070-000366
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MEDICARE SMART INC
Organization’s Mailing Address 402 S ROBERTSON BLVD APT6
City LOS ANGELES
State CA
ZIP 90048
Accounting period End 12
Primary contact name JACQUELINE BOCKAR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACQUELINE BOCKAR
CEO
402 S ROBERTSON BLVD APT6
LOS ANGELES CA 90048

Organization’s website MEDICARESMART.ORG
Organization’s email JACQUELINE@MEDICARESMART.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/12/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B99 - Education N.E.C.
Organization’s purpose Charitable: No
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 Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JACQUELINE BOCKAR
Signature Title CEO
Signature Date 3/8/19

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