FORM 1023-EZ for BACK TO BASICS FITNESS INC

Field Data
EIN 47-3775198
Case Number EO-2016020-000053
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BACK TO BASICS FITNESS INC
Organization’s Mailing Address 2836 N VERDUGO RD
City GLENDALE
State CA
ZIP 91208
Accounting period End 12
Primary contact name GAIL W MEDINA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ARTURO MEDINA
PRESIDENT
2836 N VERDUGO RD
GLENDALE CA 91208

Officer/Director/Trustee Two

GAIL MEDINA
TREASURE
2836 N VERDUGO RD
GLENDALE CA 91208

Officer/Director/Trustee Three

ORALIA SNYDER
SECRETARY
3081 PADDINGTON RD
GLENDALE CA 91206

Officer/Director/Trustee Four

BEATRIZ VILLANUEVA
MARKETING DIRECTOR
3822 SUNSET AVE
MONTROSE CA 91208

Officer/Director/Trustee Five

ROGER FREY
BOARD MEMBER
2647 ALTZIA AVE
LA CRESCENTA CA 91214

Organization’s website WWW.B2BFIT.ORG
Organization’s email B2BSTUDIO@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/18/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N30 - Physical Fitness and Community Recreational Facilities
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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