FORM 1023-EZ for THE PETROS KETEMA FOUNDATION

Field Data
EIN 47-1751543
Case Number EO-2016027-000155
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE PETROS KETEMA FOUNDATION
Organization’s Mailing Address 14938 CAMDEN AVE STE 125
City SAN JOSE
State CA
ZIP 95124
Accounting period End 12
Primary contact name GREG MCRAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARTHA KETEMA
PRESIDENT
401 VERNON STREET APT 207
OAKLAND CA 94610

Officer/Director/Trustee Two

ABEL KETEMA
SECRETARY
2405 WOODARD ROAD APT 125
SAN JOSE CA 95124

Officer/Director/Trustee Three

GINBAR KETEMA
TREASURER
2405 WOODARD ROAD APT 125
SAN JOSE CA 95124

Officer/Director/Trustee Four

MAKDA GEBREZGHI
DIRECTOR
1509 GOLDEN GATE AVE
SAN FRANCISCO CA 94115

Officer/Director/Trustee Five

YIRGALEM WOLDEMARIAM
DIRECTOR
1237 E SANTA CLARA ST APT 8
VENTURA CA 93001

Organization’s website WWW.PETROSKETEMAFOUNDATION.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/8/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T99 - Philanthropy, Voluntarism, and Grantmaking Foundations N.E.C.
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 Yes
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
Signature Title
Signature Date

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