FORM 1023-EZ for VETERANS INTEGRATIVE CARE

Field Data
EIN 83-1201989
Case Number EO-2019036-000451
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name VETERANS INTEGRATIVE CARE
Organization’s Mailing Address 709 W COLLEGE ST
City FALLBROOK
State CA
ZIP 92028-2867
Accounting period End 12
Primary contact name MARK JESINOSKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK JESINOSKI
EXECUTIVE DIRECTOR AND VICE CHAIR
709 W COLLEGE ST
FALLBROOK CA 92028-2867

Officer/Director/Trustee Two

JUSTIN CARLISLE
DEPUTY DIRECTOR AND CHAIR OF BOARD
709 W COLLEGE ST
FALLBROOK CA 92028-2867

Officer/Director/Trustee Three

ALI JESINOSKI
SECRETARY AND TREASURER
709 W COLLEGE S
FALLBROOK CA 92028-2867

Organization’s website WWW.VICARE.ORG
Organization’s email TEAMVICARE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/12/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W30 - Military, Veterans' Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 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 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 MARK JESINOSKI
Signature Title EXECUTIVE DIRECTOR AND VICE CHAIR
Signature Date 1/17/19

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