FORM 1023-EZ for BENICIA MIDDLE SCHOOL PARENT TEACHER ORGANIZATION

Field Data
EIN 84-3529231
Case Number EO-2019305-000227
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BENICIA MIDDLE SCHOOL PARENT TEACHER ORGANIZATION
Organization’s Mailing Address 1100 SOUTHAMPTON RD
City BENICIA
State CA
ZIP 94510
Accounting period End 6
Primary contact name DEBORAH ADIEGO CAGNON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEBORAH ADIEGO CAGNON
PRESIDENT
DRAKE COURT
BENICIA CA 94510

Officer/Director/Trustee Two

THELMA BENTLEY
VICE PRESIDENT
ROSE DR
BENICIA CA 94510

Officer/Director/Trustee Three

HEATHER VITALE
TREASURE
HASTINGS AVE
BENICIA CA 94510

Officer/Director/Trustee Four

SHANNON WILSON
SECRATARY
ROSE
BENICIA CA 94510

Officer/Director/Trustee Five

AMBER KELLY
PARLIAMENTARIAN
YORK
BENICIA CA 94510

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/30/19
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name AMBER KELLY
Signature Title PARLIAMENTARIAN
Signature Date 10/30/19

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