FORM 1023-EZ for INSTYLE COFFEE BYAM

Field Data
EIN 87-1662691
Case Number EO-2021231-000191
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name INSTYLE COFFEE BYAM
Organization’s Mailing Address 10240 ROSECRANS AVE UNIT 151
City BELLFLOWER
State CA
ZIP 90706
Accounting period End 12
Primary contact name RAFAEL MEDINA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RAFAEL MEDINA
OFFICER & PRESIDENT
15121 CLARK AVE
BELLFLOWER CA 90706

Officer/Director/Trustee Two

DANIEL FLORES
SECRETARY
15121 CLARK AVE
BELLFLOWER CA 90706

Officer/Director/Trustee Three

ANA MEDINA
TREASURER & DIRECTOR
15121 CLARK AVE
BELLFLOWER CA 90706

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/30/2021
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K31 - Food Banks, Food Pantries
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
Unrelated Gross Income $1,000 or More Yes
Gaming Activity No
Disaster relief assistance Yes
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 RAFAEL MEDINA
Signature Title OFFICER & PRESIDENT
Signature Date 8/17/2021

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