FORM 1023-EZ for CULTURALLY BASED ACHIEVEMENT COLLABORATIVE

Field Data
EIN 83-1927093
Case Number EO-2020078-000195
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CULTURALLY BASED ACHIEVEMENT COLLABORATIVE
Organization’s Mailing Address 15027 SHERMAN WAY UNIT A
City VAN NUYS
State CA
ZIP 91405
Accounting period End 12
Primary contact name JAMES THOMAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES THOMAS
PRESIDENT/DIRECTOR
15027 SHERMAN WAY UNIT A
VAN NUYS CA 91405

Officer/Director/Trustee Two

MONA THOMAS
TREASURER/DIRECTOR
15027 SHERMAN WAY UNIT A
VAN NUYS CA 91405

Officer/Director/Trustee Three

KELLY GRIFFIN
SECRETARY/DIRECTOR
15027 SHERMAN WAY UNIT A
VAN NUYS CA 91405

Officer/Director/Trustee Four

BRENDA ALTRIDGE
DIRECTOR
15027 SHERMAN WAY UNIT A
VAN NUYS CA 91405

Officer/Director/Trustee Five

JAMIE DOW
DIRECTOR
15027 SHERMAN WAY UNIT A
VAN NUYS CA 91405

Organization’s website
Organization’s email JAMESLWCC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/14/2018
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B99 - Education N.E.C.
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 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 JAMES THOMAS
Signature Title PRESIDENT/DIRECTOR
Signature Date 3/13/2020

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