FORM 1023-EZ for ENERGIZE RURAL HEALTH

Field Data
EIN 81-3034804
Case Number EO-2018107-000874
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ENERGIZE RURAL HEALTH
Organization’s Mailing Address 555 YGNACIO VALLEY ROAD UNIT 422
City WALNUT CREEK
State CA
ZIP 94596
Accounting period End 12
Primary contact name MARK B SAKU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ARTHUR BIKANGAGA
PRESIDENT
555 YGNACIO VALLEY ROAD UNIT 422
WALNUT CREEK CA 94596

Officer/Director/Trustee Two

ZORA BIKANGAGA
VICE-PRESIDENT
555 YGNACIO VALLEY ROAD UNIT 422
WALNUT CREEK CA 94596

Officer/Director/Trustee Three

SAMALI BIKANGAGA
SECRETARY
555 YGNACIO VALLEY ROAD UNIT 422
WALNUT CREEK CA 94596

Officer/Director/Trustee Four

MARK SAKU
TREASURER
4701 SW ADMIRAL WAY UNIT 65
SEATTLE WA 98116

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/9/16
Organization Incorporation State NV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S32 - Rural Development
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
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 MARK SAKU
Signature Title TREASURER
Signature Date 3/29/18

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