FORM 1023-EZ for DIVERSITYDHS

Field Data
EIN 81-4129886
Case Number EO-2016291-000357
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DIVERSITYDHS
Organization’s Mailing Address 14080 PALM DRIVE - SUITE D423
City DESERT HOT SPRINGS
State CA
ZIP 92240
Accounting period End 12
Primary contact name SAMUEL MESSLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SAMUEL MESSLER
PRESIDENT
66635 CASA GRANDE DRIVE
DESERT HOT SPRINGS CA 92240

Officer/Director/Trustee Two

LINDLEY KARSTENS
VICE PRESIDENT
9665 VALPARAISO DRIVE
DESERT HOT SPRINGS CA 92240

Officer/Director/Trustee Three

ALLAN SMITH
SECRETARY/TREASURER
11250 POMELO DRIVE
DESERT HOT SPRINGS CA 92240

Officer/Director/Trustee Four

FLOYD BARTEN
AT-LARGE DIRECTOR
14080 PALM DRIVE - SUITE 506
DESERT HOT SPRINGS CA 92240

Officer/Director/Trustee Five

GEORGE FISHER
AT-LARGE DIRECTOR
66671 SAN MARCUS
DESERT HOT SPRINGS CA 92240

Organization’s website WWW.DIVERSITYDHS.COM
Organization’s email DIVERSITYDHS@ROADRUNNER.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/14/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code R26 - Lesbian, Gay Rights
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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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