FORM 1023-EZ for JAI TOME JEMS

Field Data
EIN 47-4882262
Case Number EO-2015344-000498
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JAI TOME JEMS
Organization’s Mailing Address 740 SUNDANCE PLACE
City APPLEGATE
State CA
ZIP 95703
Accounting period End 12
Primary contact name KELLY FULFER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KELLY FULFER
SECRETARY
740 SUNDANCE PLACE
APPLEGATE CA 95703

Officer/Director/Trustee Two

JOANNE VALENTINE
CEO
3295 SUNSET TERRACE
AUBURN CA 95602

Officer/Director/Trustee Three

LINDA MAEDING
DIRECTOR
20775 MAGNOLIA RANCH RD
WEIMAR CA 95736

Officer/Director/Trustee Four

KELLY COOPER
CFO
13063 LINCOLN WAY
AUBURN CA 95603

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/14/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O12 - Fund Raising and/or Fund Distribution
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 Yes
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
Signature Title
Signature Date

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