FORM 1023-EZ for NORTHERN CALIFORNIA KYUDO FEDERATION

Field Data
EIN 38-4003329
Case Number EO-2016224-000392
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NORTHERN CALIFORNIA KYUDO FEDERATION
Organization’s Mailing Address 202 SYLVAN WAY
City LA HONDA
State CA
ZIP 94020-9776
Accounting period End 3
Primary contact name ANDREW PLATZER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARIA PETERSON
PRESIDENT
PO BOX 68
LA HONDA CA 94020-0068

Officer/Director/Trustee Two

HAITHAM SHAMAA
SECRETARY
716 2ND AVE UNIT 7
SAN FRANCISCO CA 94118-4042

Officer/Director/Trustee Three

NANCY HSIEH
TREASURER
1599 S BLANEY AVE
SAN JOSE CA 95129-3713

Organization’s website HTTP://WWW.KYUDO.COM/NCKF.HTML
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 N50 - Recreational, Pleasure, or Social Club
Organization’s purpose Charitable: No
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 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
Signature Title
Signature Date

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