FORM 1023-EZ for SAMBOS USA INC

Field Data
EIN 46-3805608
Case Number EO-2019035-000956
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SAMBOS USA INC
Organization’s Mailing Address 5203 8TH RD SOUTH APT202
City ARLINGTON
State VA
ZIP 22204
Accounting period End 12
Primary contact name JUAN CARLOS CADIMA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JUAN CARLOS CADIMA
PRESIDENT
5203 8TH RD SOUTH APT202
ARLINGTON VA 22204

Officer/Director/Trustee Two

RANDY OLIVER CADIMA
VICE-PRESIDENT
7611 ROANOKE AVE
ANNANDALE VA 22003

Officer/Director/Trustee Three

MARIA ELENA CADIMA
TREASURER/SECRETARY
7611 ROANOKE AVE
ANNANDALE VA 22003

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/27/13
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 JUAN CARLOS CADIMA
Signature Title PRESIDENT
Signature Date 1/15/19

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