FORM 1023-EZ for INTERNATIONAL COLLEGIATE HEALTH INITIATIVE
| Field | Data |
|---|---|
| EIN | 82-2068216 |
| Case Number | EO-2018093-000012 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | INTERNATIONAL COLLEGIATE HEALTH INITIATIVE |
| Organization’s Mailing Address | 200 DE NEVE DRIVE |
| City | LOS ANGELES |
| State | CA |
| ZIP | 90095 |
| Accounting period End | 9 |
| Primary contact name | AHMAD ELHAIJA |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
AHMAD ELHAIJA
CHIEF EXECUTIVE OFFICER
846 CRESTMONT CIR
CORONA CA 92882
Officer/Director/Trustee Two
ALIEF ISHMAM
WEBSITE DEVELOPER
841 RANCH VISTA ROAD
CORONA CA 92879
Officer/Director/Trustee Three
DIEGO ZAVALA
CHIEF FINANCIAL OFFICER
2580 SENTER ROAD
SAN JOSE CA 95111
Officer/Director/Trustee Four
ASHIN JOSE
BOARD PRESIDENT
13405 EAGLEBLUFF LANE
CORONA CA 92880
| Organization’s website | WWW.ICHEALTHINITIATIVE.ORG |
|---|---|
| Organization’s email | ICHI@ICHEALTHINITIATIVE.ORG |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 12/27/17 |
| Organization Incorporation State | CA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P20 - Human Service Organizations - Multipurpose |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes Scientific: Yes Literary: No Public Safety: No Amateur Sports: No Cruelty Prevention: No |
| Qualify For Exemption | No |
| Legislation influence | No |
| Compensation of Officer director trustee | Yes |
| Donation of funds | Yes |
| Conducting Activities Outside of United States | Yes |
| Financial transactions with officers | No |
| Unrelated Gross Income $1,000 or More | No |
| Gaming Activity | No |
| Disaster relief assistance | Yes |
| 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 | AHMAD ELHAIJA |
| Signature Title | CHIEF EXECUTIVE OFFICER |
| Signature Date | 3/30/18 |
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