FORM 1023-EZ for ALL4MVMT HEALTH PROJECT

Field Data
EIN 84-3773178
Case Number EO-2019333-000177
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ALL4MVMT HEALTH PROJECT
Organization’s Mailing Address 185 ESTANCIA DR UNIT 208
City SAN JOSE
State CA
ZIP 95134
Accounting period End 12
Primary contact name KALE PTACEK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KALE PTACEK
DIRECTOR, PRESIDENT
185 ESTANCIA DR UNIT 208
SAN JOSE CA 95134

Officer/Director/Trustee Two

KEVIN KWOK
DIRECTOR, TREASURER
185 ESTANCIA DR UNIT 208
SAN JOSE CA 95134

Officer/Director/Trustee Three

SCOTT KIRKLAND
DIRECTOR, SECRETARY
185 ESTANCIA DR UNIT 208
SAN JOSE CA 95134

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/4/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion 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 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 KALE PTACEK
Signature Title DIRECTOR, PRESIDENT
Signature Date 11/26/19

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