FORM 1023-EZ for THE FREE A SMILE CORPORATION

Field Data
EIN 81-1616912
Case Number EO-2016113-000131
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE FREE A SMILE CORPORATION
Organization’s Mailing Address 11561 SYLVAN ST 3
City NORTH HOLLYWOOD
State CA
ZIP 91606
Accounting period End 12
Primary contact name GYE DI CAPUA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GYE DI CAPUA
PRESIDENT
11561 SYLVAN ST 3
NORTH HOLLYWOOD CA 91606

Officer/Director/Trustee Two

HELEN STALEY
SECRETARY
13914 BESSEMER ST
NORTH HOLLYWOOD CA 91401

Officer/Director/Trustee Three

CARRIE CAVILIER
TREASURER
3200 WYOMING AVE
BURBANK CA 91505

Organization’s website
Organization’s email FREEASMILE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/29/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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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