FORM 1023-EZ for SANTA CLARITA ELKS LODGE NO 2379 CHARITABLE FUND

Field Data
EIN 80-0189834
Case Number EO-2015310-000158
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SANTA CLARITA ELKS LODGE NO 2379 CHARITABLE FUND
Organization’s Mailing Address 17766 SIERRA HWY
City CANYON COUNTRY
State CA
ZIP 91351
Accounting period End 3
Primary contact name CHERYL LAYMON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOHN RIVETTI
PRESIDENT
17766 SIERRA HWY
CANYON COUNTRY CA 91351

Officer/Director/Trustee Two

CHERYL LAYMON
SECRETARY
17766 SIERRA HWY
CANYON COUNTRY CA 91351

Officer/Director/Trustee Three

LARRY LOUSBERG
DIRECTOR
17766 SIERRA HWY
CANYON COUNTRY CA 91351

Officer/Director/Trustee Four

JAY LARKINS
DIRECTOR
17766 SIERRA HWY
CANYON COUNTRY CA 91351

Officer/Director/Trustee Five

SKIP HENKE
DIRECTOR
17766 SIERRA HWY
CANYON COUNTRY CA 91351

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/30/2005
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y03 - Professional Societies, Associations
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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