FORM 1023-EZ for PROUD MOUSE

Field Data
EIN 81-4240519
Case Number EO-2017024-000230
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PROUD MOUSE
Organization’s Mailing Address 11117 SCRIPPS RANCH BLVD
City SAN DIEGO
State CA
ZIP 92131
Accounting period End 10
Primary contact name GHADIR MOUNIB
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GHADIR MOUNIB
PRESIDENT
11117 SCRIPPS RANCH BLVD
SAN DIEGO CA 92131

Officer/Director/Trustee Two

MARK STEPHAN
VICE PRESIDENT
11027 TURRET DRIVE
SAN DIEGO CA 92131

Organization’s website WWW.PROUDMOUSE.COM
Organization’s email GHADIR@PROUDMOUSE.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/11/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A60 - Performing Arts Organizations
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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