FORM 1023-EZ for SHASTA YOUTH ALLIANCE

Field Data
EIN 83-1766811
Case Number EO-2018256-000403
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHASTA YOUTH ALLIANCE
Organization’s Mailing Address 2205 HILLTOP DRIVE 20
City REDDING
State CA
ZIP 96002
Accounting period End 12
Primary contact name MELISSA ELLIOTT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JIM ELLIOTT
PRESIDENT
2190 WESTERN OAK DR
REDDING CA 96002

Officer/Director/Trustee Two

KRISTIN VISCONTI
SECRETARY
2190 WESTERN OAK DR
REDDING CA 96002

Organization’s website
Organization’s email SHASTAYOUTH@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/1/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A01 - Alliance/Advocacy Organizations
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 No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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 JIM ELLIOTT
Signature Title PRESIDENT
Signature Date 9/11/18

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