FORM 1023-EZ for LOS ALISOS MIDDLE SCHOOL MUSIC BOOSTER CLUB

Field Data
EIN 47-2656683
Case Number EO-2015030-000575
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LOS ALISOS MIDDLE SCHOOL MUSIC BOOSTER CLUB
Organization’s Mailing Address 14800 SOUTH JERSEY AVENUE ROOM 131
City NORWALK
State CA
ZIP 90650-5849
Accounting period End 12
Primary contact name ATULKUMAR BHAKTA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT MEDINA
PRESIDENT
14800 SOUTH JERSEY AVENUE ROOM 131
NORWALK CA 90650-5849

Officer/Director/Trustee Two

SARAY DEL RIO
VICE PRESIDENT
14800 SOUTH JERSEY AVENUE ROOM 131
NORWALK CA 90650-5849

Officer/Director/Trustee Three

TRISH ROSALES
SECRETARY
14800 SOUTH JERSEY AVENUE ROOM 131
NORWALK CA 90650-5849

Officer/Director/Trustee Four

MARIBEL SOTO
AUDITOR
14800 SOUTH JERSEY AVENUE ROOM 131
NORWALK CA 90650-5849

Officer/Director/Trustee Five

ATULKUMAR BHAKTA
TREASURER
11544 IMPERIAL HWY APT 05
NORWALK CA 90650-2815

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B94 - Parent/Teacher Group
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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