FORM 1023-EZ for SAVE OUR SMILES SPORTS GUARD FOUNDATION

Field Data
EIN 81-3342451
Case Number EO-2016210-000033
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SAVE OUR SMILES SPORTS GUARD FOUNDATION
Organization’s Mailing Address 4772 BAYTREE PLACE
City SANTA ROSA
State CA
ZIP 95405-8792
Accounting period End 12
Primary contact name RONALD E COX DDS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RONALD COX
CEO
4772 BAYTREE PLACE
SANTA ROSA CA 95405-8792

Officer/Director/Trustee Two

CAROL COX
SECRETARY
4772 BAYTREE PLACE
SANTA ROSA CA 95405-8792

Officer/Director/Trustee Three

CAROL COX
TREASURE
4772 BAYTREE PLACE
SANTA ROSA CA 95405-8792

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/29/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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
Signature Title
Signature Date

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