FORM 1023-EZ for ACHOR VALLEY ASSOCIATION AVA INC

Field Data
EIN 84-2406701
Case Number EO-2019357-000420
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ACHOR VALLEY ASSOCIATION AVA INC
Organization’s Mailing Address 8251 LA PALMA AVE UNIT 234
City BUENA PARK
State CA
ZIP 90620
Accounting period End 7
Primary contact name JETTA BAPTISTE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JETTA BAPTISTE
PRESIDENT
8251 LA PALMA AVE UNIT 234
BUENA PARK CA 90620

Officer/Director/Trustee Two

JACKLYN FLOWERS
TREASURER AND DIRECTOR
24255 BRIONES DR
LAGUNA NIGUEL CA 92677

Officer/Director/Trustee Three

CHEEKERRA J SMITH
SECRETARY AND DIRECTOR
8251 LA PALMA AVE UNIT 234
BUENA PARK CA 90620

Officer/Director/Trustee Four

MIRIAM GOITOM
DIRECTOR
5916 BURNHAM AVE APT 7
BUENA PARK CA 90621

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/2019
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L80 - Housing Support Services -- Other
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 Yes
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 JETTA BAPTISTE
Signature Title PRESIDENT
Signature Date 12/20/2019

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