FORM 1023-EZ for ROSEVILLE HOST LIONS CLUB FOUNDATION

Field Data
EIN 82-2232045
Case Number EO-2017278-000522
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROSEVILLE HOST LIONS CLUB FOUNDATION
Organization’s Mailing Address PO BOX 806
City ROSEVILLE
State CA
ZIP 95678
Accounting period End 6
Primary contact name EDWARD A SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSEPH FLORES
PRESIDENT
2652 ROGUE WAY
ROSEVILLE CA 95747

Officer/Director/Trustee Two

EDWARD SMITH
SECRETARY
1416 VALLEY GLEN DR
ROSEVILLE CA 95747

Officer/Director/Trustee Three

BERNARD MILMOE
TREASURER
204 ST ANNES PLACE
ROSEVILLE CA 95678

Officer/Director/Trustee Four

JOE ESPARZA
DIRECTOR
647 GRIDER DR
ROSEVILLE CA 95678

Officer/Director/Trustee Five

FRANK KAGARAKIS
DIRECTOR
206 ST ANNES PLACE
ROSEVILLE CA 95678

Organization’s website WWW.ROSEVILLEHOSTLIONS.ORG
Organization’s email LIONEDSMITH@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/10/2017
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
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 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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