FORM 1023-EZ for EYESHINE

Field Data
EIN 45-4158656
Case Number EO-2018213-000239
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EYESHINE
Organization’s Mailing Address 64 BRISTOL PLACE
City GOLETA
State CA
ZIP 93117
Accounting period End 12
Primary contact name DUDLEY CONNEELY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DUDLEY CONNEELY
EXECUTIVE DIRECTOR
64 BRISTOL PLACE
GOLETA CA 93117

Officer/Director/Trustee Two

DARCY CHRISTAL
SENIOR ADVISOR
1482 EAST VALLEY RD
SANTA BARBARA CA 93108

Officer/Director/Trustee Three

FERNANDO RAMIREZ
TRUSTEE
2015 CASTILLO APT C
SANTA BARBARA CA 93101

Officer/Director/Trustee Four

BRIANNA PETTIT
PROGRAM DIRECTOR
71 A NORTH SAN MARCOS RD
SANTA BARBARA CA 93111

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/24/14
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P86 - Blind/Visually Impaired Centers, Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 Yes
Correctness Declaration Yes
Signature Name DUDLEY CONNEELY
Signature Title EXECUTIVE DIRECTOR
Signature Date 7/30/18

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