FORM 1023-EZ for MIXED BEHAVIOR FOUNDATION
| Field | Data |
|---|---|
| EIN | 86-3450379 |
| Case Number | EO-2021116-000657 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | MIXED BEHAVIOR FOUNDATION |
| Organization’s Mailing Address | 2872 YGNACIO VALLEY RD UNIT 439 |
| City | WALNIT CREEK |
| State | CA |
| ZIP | 94598 |
| Accounting period End | 12 |
| Primary contact name | SASHA DELANEY |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
SASHA DELANEY
CFO
2872 YGNACIO VALLEY RD UNIT 439
WALNUT CREEK CA 94598
Officer/Director/Trustee Two
ALONZO JACKSON
CEO
2872 YGNACIO VALLEY RD UNIT 439
WALNUT CREEK CA 94598
Officer/Director/Trustee Three
PEAA HATFIELD
SECRETARY
2114 11TH AVE
OAKLAND CA 94606
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/27/2020 |
| Organization Incorporation State | CA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | O50 - Youth Development Programs, Other |
| Organization’s purpose | Charitable: No Religious: No Educational: Yes 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 | Yes |
| Donation of funds | Yes |
| 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 | No |
| Correctness Declaration | Yes |
| Signature Name | SASHA DELANEY |
| Signature Title | CFO |
| Signature Date | 4/23/2021 |
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