FORM 1023-EZ for SAN JOAQUIN DENTAL SOCIETY FOUNDATION

Field Data
EIN 85-0979247
Case Number EO-2020192-000307
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SAN JOAQUIN DENTAL SOCIETY FOUNDATION
Organization’s Mailing Address 7849 N PERSHING AVE
City STOCKTON
State CA
ZIP 95207
Accounting period End 12
Primary contact name MARK ALCORN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRUCE TOY
CHAIR/DIRECTOR
7849 N PERS
STOCKTON CA 95207

Officer/Director/Trustee Two

BILL MARWEG
VICECHAIR/DIRECTOR
7849 N PERSHING AVE
STOCKTON CA 95207

Officer/Director/Trustee Three

JANICE SCOTT
TREASURER/DIRECTOR
7849 N PERSHING AVE
STOCKTON CA 95207

Officer/Director/Trustee Four

ROMMEL BAL
SECRETARY/DIRECTOR
7849 N PERSHING AVE
STOCKTON CA 95207

Organization’s website NONE.
Organization’s email EXECUTIVE@SJDS.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/30/2020
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name BRUCE TOY
Signature Title CHAIR/DIRECTOR
Signature Date 7/8/2020

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