FORM 1023-EZ for WOMEN SPORTS SAFETY INITIATIVE

Field Data
EIN 82-4129051
Case Number EO-2018106-001178
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WOMEN SPORTS SAFETY INITIATIVE
Organization’s Mailing Address 500 CAPITOL MALL SUITE 2350
City SACRAMENTO
State CA
ZIP 95814
Accounting period End 12
Primary contact name MARY HAYASHI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARY HAYASHI
EXECUTIVE DIRECTOR
500 CAPITOL MALL SUITE 2350
SACRAMENTO CA 95814

Officer/Director/Trustee Two

AFTON KOBAYASHI
SECRETARY/TREASURER
500 CAPITOL MALL SUITE 2350
SACRAMENTO CA 95814

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/2/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E05 - Research Institutes and/or Public Policy Analysis
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 MARY HAYASHI
Signature Title EXECUTIVE DIRECTOR
Signature Date 4/13/18

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