FORM 1023-EZ for CONVALESCENT HOSPITAL MINISTRY OF SANTA CLARA VALLEY

Field Data
EIN 77-0020658
Case Number EO-2019277-001011
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CONVALESCENT HOSPITAL MINISTRY OF SANTA CLARA VALLEY
Organization’s Mailing Address 1710 MOORPARK AVE
City SAN JOSE
State CA
ZIP 95128
Accounting period End 12
Primary contact name IDA STRICKLAND
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

IDA STRICKLAND
PRESIDENT
143 OLD ORCHARD DR
LOS GATOS CA 95032

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/4/84
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name IDA STRICKLAND
Signature Title PRESIDENT
Signature Date 10/2/19

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