FORM 1023-EZ for WORKABILITY REGION 4 INC

Field Data
EIN 47-4556535
Case Number EO-2015236-000156
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WORKABILITY REGION 4 INC
Organization’s Mailing Address 3111 CENTER COURT LANE 700
City ANTELOPE
State CA
ZIP 95843
Accounting period End 6
Primary contact name JOANNE SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOANNE SMITH
CHIEF EXECUTIVE OFFICE
9510 ELK GROVE-FLORIN ROAD
ELK GROVE CA 95624

Officer/Director/Trustee Two

BARBARA WATTS
SECRETARY
1710 CIRBY WAY
ROSEVILLE CA 95691

Officer/Director/Trustee Three

SHAWNA PACHECO
TREASURER
3111 CENTER COUT LANE 700
ANTELOPE CA 95843

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/7/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
Organization’s purpose Charitable: No
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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