FORM 1023-EZ for GO BACK INC

Field Data
EIN 81-1228500
Case Number EO-2016084-000281
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GO BACK INC
Organization’s Mailing Address 1951 OLIVE AVE
City LONG BEACH
State CA
ZIP 90806
Accounting period End 12
Primary contact name SHYNEISHA ROUSE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SHYNEISHA ROUSE
CHIEF EXECUTIVE OFFICER
25 CLAREMONT AVE
LONG BEACH CA 90803

Officer/Director/Trustee Two

CHARLES COBB
CHIEF FINANCIAL OFFICER
25 CLAREMONT AVE APT 8
LONG BEACH CA 90803

Organization’s website N/A
Organization’s email GOBACKINC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/11/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
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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