FORM 1023-EZ for POSILIVE PROJECT

Field Data
EIN 47-3676647
Case Number EO-2015105-000220
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name POSILIVE PROJECT
Organization’s Mailing Address PO BOX 9306
City BERKELEY
State CA
ZIP 94709-0306
Accounting period End 12
Primary contact name NAYER KHAZENI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BRYAN KONO
CEO
1560 ADAMS LANE
DENVER CO 80206-1706

Officer/Director/Trustee Two

TARA EMRICK
CFO
1560 ADAMS LANE
DENVER CO 80206-1706

Officer/Director/Trustee Three

HANK CHEN
SECRETARY
1001 SNEATH LANE
SAN BRUNO CA 94066-2308

Officer/Director/Trustee Four

NAYER KHAZENI
FOUNDER
1721 LINCOLN STREET
BERKELEY CA 94703-1308

Organization’s website WWW.POSILIVEPROJECT.COM
Organization’s email INFO@POSILIVEPROJECT.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/5/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
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 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
Signature Title
Signature Date

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