FORM 1023-EZ for LULU NURSE

Field Data
EIN 85-1723967
Case Number EO-2020224-000153
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LULU NURSE
Organization’s Mailing Address 26882 GREENLEAF COURT
City VALENCIA
State CA
ZIP 91381
Accounting period End 12
Primary contact name AMY BONDURANT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMY BONDURANT
PRESIDENT/DIRECTOR
7611 W GREENLAKE DR
SEATTLE WA 98103

Officer/Director/Trustee Two

RICK GOMBOS
SECRETARY/TREASURER/DIRECTOR
26882 GREENLEAF COURT
VALENCIA CA 91381

Officer/Director/Trustee Three

ROBERT BLAND
DIRECTOR
26882 GREENLEAF COURT
26882 GREENLEAF COUR CA 91381

Organization’s website
Organization’s email RGOMBOS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/15/2020
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 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 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 AMY BONDURANT
Signature Title PRESIDENT/DIRECTOR
Signature Date 8/6/2020

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