FORM 1023-EZ for AMBER GROVE NEIGHBORHOOD SAFETY GROUP

Field Data
EIN 86-3102222
Case Number EO-2021116-000318
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AMBER GROVE NEIGHBORHOOD SAFETY GROUP
Organization’s Mailing Address 155 GREENFIELD DRIVE
City CHICO
State CA
ZIP 95973-0187
Accounting period End 12
Primary contact name MARK PING - PRESIDENT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK PING
PRESIDENT
155 GREENFIELD DRIVE
CHICO CA 95973-0187

Officer/Director/Trustee Two

JOEL BIDDLE
TREASURER
3114 CALISTOGA DR
CHICO CA 95973-0181

Officer/Director/Trustee Three

KIM JERGENTZ
SECRETARY
3198 EAGLE LAKE CT
CHICO CA 95973-0184

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/12/2021
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I12 - Fund Raising and/or Fund Distribution
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 MARK PING
Signature Title PRESIDENT
Signature Date 4/22/2021

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