FORM 1023-EZ for BELGRAVE RECOVERY CENTER

Field Data
EIN 81-4440773
Case Number EO-2016323-000344
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BELGRAVE RECOVERY CENTER
Organization’s Mailing Address 2668 BELGRAVE AVENUE
City HUNTINGTON PARK
State CA
ZIP 90255
Accounting period End 6
Primary contact name RONDA DIXON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CARLOS SANCHEZ
PRESIDENT
202 E COMMONWEALTH AVE APT 565
FULLERTON CA 92836

Officer/Director/Trustee Two

ROSSANNA LICEA
SECRETARY
2648 CALIFORNIA STREET
HUNTINGTON PARK CA 90255

Officer/Director/Trustee Three

EFFI AZARMIR
TREASURER
4706 SEPULVEDA BLVD APT 209
SHERMAN OAKS CA 91403

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/25/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F33 - Group Home, Residential Treatment Facility - Mental Health Related
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 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
Signature Title
Signature Date

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