FORM 1023-EZ for CANCERBASE INCORPORATED

Field Data
EIN 81-2551047
Case Number EO-2016159-000129
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CANCERBASE INCORPORATED
Organization’s Mailing Address 24 PETER COUTTS CIRCLE
City STANFORD
State CA
ZIP 94305
Accounting period End 5
Primary contact name JAN LIPHARDT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAN LIPHARDT
PRESIDENT
24 PETER COUTTS CIRCLE
STANFORD CA 94305

Organization’s website WWW.CANCERBASE.ORG
Organization’s email JTLIPHARDT@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/9/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H30 - Cancer Research
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 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 No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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