FORM 1023-EZ for CHILD CANCER SERVICES FOUNDATION

Field Data
EIN 82-1896087
Case Number EO-2017174-000140
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHILD CANCER SERVICES FOUNDATION
Organization’s Mailing Address 8 THE GREEN STE B211
City DOVER
State DE
ZIP 19901
Accounting period End 12
Primary contact name JAMES WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES WILLIAMS
PRESIDENT, TREASURER, DIRECTOR
4343 N 78TH ST STE A214
SCOTTSDALE AZ 85251

Officer/Director/Trustee Two

DEWAYNE WILLIAMS
SECRETARY, DIRECTOR
218 S 3RD ST
RICHMOND CA 94804

Officer/Director/Trustee Three

DANIEL WEIS
DIRECTOR
3749 STANFORD DR
OCEANSIDE CA 92056

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/7/2017
Organization Incorporation State DE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
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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