FORM 1023-EZ for TEETH FOR SURVIVORS

Field Data
EIN 82-0851206
Case Number EO-2017080-000180
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TEETH FOR SURVIVORS
Organization’s Mailing Address 701 HOWE AVE UNIT B34
City SACRAMENTO
State CA
ZIP 95825-4604
Accounting period End 12
Primary contact name SERGEY MAHTESYAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SERGEY MAHTESYAN
CEO
701 HOWE AVE UNIT B34
SACRAMENTO CA 95825-4604

Officer/Director/Trustee Two

NARA MIRZOYAN
CFO
701 HOWE AVE UNIT B34
SACRAMENTO CA 95825-4604

Officer/Director/Trustee Three

ARTUR MIRZOYAN
CHAIRMAN OF THE BOARD
701 HOWE AVE UNIT B34
SACRAMENTO CA 90038-4604

Officer/Director/Trustee Four

ZHIRAYR HAKOBYAN
DIRECTOR
701 HOWE AVE UNIT B34
SACRAMENTO CA 90038-4604

Officer/Director/Trustee Five

LAVINIA LIN
DIRECTOR
701 HOWE AVE UNIT B34
SACRAMENTO CA 90038-4604

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/2/2017
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P62 - Victims' Services
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
Signature Title
Signature Date

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