FORM 1023-EZ for SAN FRANCISCO SAFETY AND WELLNESS COALITION

Field Data
EIN 46-5140543
Case Number EO-2014272-000232
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SAN FRANCISCO SAFETY AND WELLNESS COALITION
Organization’s Mailing Address 1189 SOUTH VAN NESS
City SAN FRANCISCO
State CA
ZIP 94110
Accounting period End 12
Primary contact name JESSE D PALMER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MICHAEL SIEVER
CEO DIRECTOR
1189 SOUTH VAN NESS
SAN FRANCISCO CA 94110

Officer/Director/Trustee Two

HOLLY BRADFORD
SECRETARY DIRECTOR
149 TURK STREET
SAN FRANCISCO CA 94102

Officer/Director/Trustee Three

ANDREW REYNOLDS
CFO DIRECTOR
3901 ENOS
OAKLAND CA 94619

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/19/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 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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