FORM 1023-EZ for KOINONIA RESOURCE CENTER

Field Data
EIN 83-1756782
Case Number EO-2018309-000293
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KOINONIA RESOURCE CENTER
Organization’s Mailing Address 2598 AYALA DR 47
City RIALTO
State CA
ZIP 92377
Accounting period End 12
Primary contact name VERETTA ELMORE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIM GRAYS
PRESIDENT
2598 AYALA DR 47
RIALTO CA 92377

Officer/Director/Trustee Two

ANTIONETTE JERRICKS
92377
2598 AYALA DR47
RIALTO CA 92377

Officer/Director/Trustee Three

LAODECIS WALKER
SECRETARY/TREASURER
2598 AYALA DR 47
RIALTO CA 92377

Officer/Director/Trustee Four

VERETTA ELMORE
EXECUTIVE DIRECTOR
2598 AYALA DR 47
RIALTO CA 92377

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/6/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P85 - Homeless Persons Centers, Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 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 VERETTA ELMORE
Signature Title EXECUTIVE DIRECTOR
Signature Date 11/1/18

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