FORM 1023-EZ for GUAM SEXUAL ASSAULT AND ABUSE RESOURCE CENTER ASSOCIATION

Field Data
EIN 66-0706890
Case Number EO-2015104-000058
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GUAM SEXUAL ASSAULT AND ABUSE RESOURCE CENTER ASSOCIATION
Organization’s Mailing Address 133 LAGOON DRIVE
City TAMUNING
State GU
ZIP 96913-3213
Accounting period End 12
Primary contact name ELLEN P BEZ MD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ELLEN BEZ MD
PRESIDENT
133 LAGOON DRIVE
TAMUNING GU 96913-3213

Officer/Director/Trustee Two

ANNIE UNDERWOOD BORDALLO MD
TREASURER
133 LAGOON DRIVE
TAMUNING GU 96913-3213

Officer/Director/Trustee Three

JO ANN RIVERA
VICE-PRESIDENT
241 CONDO LANE ALUPANG COVE 519
TAMUNING GU 96913

Officer/Director/Trustee Four

LYDIA TENORIO
SECRETARY
390 CHALAN MAKHNA
AGANA HEIGHTS GU 96919

Officer/Director/Trustee Five

LOURDES LEON GUERRERO
MEMBER
BANK OF GUAM 10TH FLOOR
HAGATNA GU 96932

Organization’s website
Organization’s email GUAMSAACRA@YAHOO.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/11/2008
Organization Incorporation State GU
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F42 - Rape Victim Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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