FORM 1023-EZ for NADEZHDA HEALTH PROJECT

Field Data
EIN 82-2852928
Case Number EO-2019029-000544
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NADEZHDA HEALTH PROJECT
Organization’s Mailing Address CSI BOX795 UC DAVIS ONE SHIELDS AVE
City DAVIS
State CA
ZIP 95616
Accounting period End 12
Primary contact name ILYA KHAMISHON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANNA KIRILLOVA
PRESIDENT
4817 EL GRANDE PLACE
EL SOBRANTE CA 94803

Officer/Director/Trustee Two

YELIZAVETA BELOMYTTSEVA
VICE PRESIDENT
11876 WHITE RAIN WAY
RANCHO CORDOVA CA 95742

Officer/Director/Trustee Three

MARINA SHATSKIKH
SECRETARY
72 REUNION
IRVINE CA 92603

Officer/Director/Trustee Four

ILYA KHAMISHON
MEDICAL DIRECTOR
4304 ESPLANADE CIR
FOLSOM CA 95630

Officer/Director/Trustee Five

SERGEY VERETENNIKOV
MEDICAL STUDENT DIRECTOR
2734 SAN JOSE WAY APT 4
SACRAMENTO CA 95817

Organization’s website
Organization’s email NADEZHDAHEALTH@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/25/18
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: 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 ANNA KIRILLOVA
Signature Title PRESIDENT
Signature Date 12/20/18

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