FORM 1023-EZ for KRAMA BALI LOS ANGELES

Field Data
EIN 85-1289636
Case Number EO-2020237-000493
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KRAMA BALI LOS ANGELES
Organization’s Mailing Address 23202 REDBUD RIDGE CIR
City VALENCIA
State CA
ZIP 91354
Accounting period End 12
Primary contact name I NYOMAN WENTEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DESAK NYOMAN SRI GESTARI
PRESIDENT
6743 LENNOX AVE
VAN NUYS CA 91405

Officer/Director/Trustee Two

IDA AYU MARTIANI
TREASURER/CFO
728 S FIR AVE -17
INGLEWOOD CA 90301

Officer/Director/Trustee Three

KADEK HEMAWAN
SECRETARY/DIRECTOR
7375 STONEBROOK PL
RANCHO CUCAMONGA CA 91730

Officer/Director/Trustee Four

I NYOMAN WENTEN
DIRECTOR/CHAIRMAN OF BOARD OF DIREC
23202 REDBUD RIDGE CIR
VALENCIA CA 91354

Officer/Director/Trustee Five

I MADE SUTJITA
DIRECTOR
13561 STACY LYNN DR
MORENO VALLEY CA 92555

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/18/2020
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A23 - Cultural, Ethnic Awareness
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 Yes
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 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 DESAK NYOMAN SRI GESTARI
Signature Title PRESIDENT
Signature Date 8/21/2020

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