FORM 1023-EZ for 160 BLACKJACK ASSOCIATION
| Field | Data |
|---|---|
| EIN | 83-1237546 |
| Case Number | EO-2019323-000286 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | 160 BLACKJACK ASSOCIATION |
| Organization’s Mailing Address | 1336 DICKSON AVE |
| City | LOS ANGELESC |
| State | CA |
| ZIP | 90063 |
| Accounting period End | 7 |
| Primary contact name | TIMOTHY SUWANDHAPUTRA |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
TIMOTHY SUWANDHAPUTRA
MANAGING BOARD MEMBER
3611 COLE AVE APT 173
DALLAS TX 75204
Officer/Director/Trustee Two
KRISTIAN LEWIS
BOARD MEMBER
1336 DICKSON AVE
LOS ANGELES CA 90063
Officer/Director/Trustee Three
ANTHONY BANGLOY
BOARD MEMBER
8427 JUSTAWEE COURT
ELK GROVE CA 95624
| Organization’s website | 160INFANTRY.ORG |
|---|---|
| Organization’s email | |
| Organization Incorporated | No |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 7/16/2018 |
| Organization Incorporation State | CA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | W30 - Military, Veterans' Organizations |
| Organization’s purpose | Charitable: Yes 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 | 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 | 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 | TIMOTHY SUWANDHAPUTRA |
| Signature Title | MANAGING BOARD MEMBER |
| Signature Date | 11/17/2019 |
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