FORM 1023-EZ for INDONESIAN CIVIL ENGINEERS SOCIETYOF NORTH AMERICA - ICESNA INC

Field Data
EIN 83-4522112
Case Number EO-2020076-000519
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name INDONESIAN CIVIL ENGINEERS SOCIETYOF NORTH AMERICA - ICESNA INC
Organization’s Mailing Address 2347 MILTON PL
City ALPHARETTA
State GA
ZIP 30004-5165
Accounting period End 12
Primary contact name MARTIN CHANDRAWINATA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WIRA TJONG
PRESIDENT
25600 SECRET MEADOWS DR
CASTRO VALLEY CA 94552

Officer/Director/Trustee Two

MARTIN CHANDRAWINATA
TREASURER
1173 66TH STREET
OAKLAND CA 94608

Officer/Director/Trustee Three

ANDREAS KRISTANTO
DIRECTOR
2347 MILTON PLACE
ALPHARETTA GA 30004

Officer/Director/Trustee Four

TEDDY THERYO
DIRECTOR
3550 ESPLANADE WAY APT 11105
TALLAHASSEE FL 32311

Officer/Director/Trustee Five

MARIA MUNGENAST
SECRETARY
8213 STOCKTON WAY
TAMPA FL 33647

Organization’s website WWW.ICESNA.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/3/2019
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A03 - Professional Societies, Associations
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 Yes
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 WIRA TJONG
Signature Title PRESIDENT
Signature Date 3/14/2020

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