FORM 1023-EZ for SHOSHIN KAI INC A NON PROFIT PUBLICBENEFIT CORPORATION

Field Data
EIN 47-2763682
Case Number EO-2020244-000347
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHOSHIN KAI INC A NON PROFIT PUBLICBENEFIT CORPORATION
Organization’s Mailing Address 6641 FULTON AVENUE
City VAN NUYS
State CA
ZIP 91401
Accounting period End 12
Primary contact name DERICK MARTINEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DERICK MARTINEZ
CEO
6641 FULTON AVENUE
VAN NUYS CA 91401

Organization’s website WWW.SHOSHINKAIKARATE.COM
Organization’s email SENSEIDERICK@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/24/2014
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: 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name DERICK MARTINEZ
Signature Title CEO
Signature Date 8/27/2020
EIN 47-2763682
Case Number EO-2015021-000300
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SHOSHIN KAI INC A NONPROFIT PUBLICBENEFIT CORPORATION
Organization’s Mailing Address 6641 FULTON AVENUE
City VAN NUYS
State CA
ZIP 91401
Accounting period End 12
Primary contact name DERICK MARTINEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DERICK MARTINEZ
PRESIDENT, DIRECTOR
6641 FULTON AVENUE
Van Nuys CA 91401

Officer/Director/Trustee Two

JOSE ANGEL ARGUETA
VICE PRESIDENT, DIRECTOR
6641 FULTON AVENUE
Van Nuys CA 91401

Officer/Director/Trustee Three

GIMENA VALENZUELA
CHIEF FINANCIAL OFFICER, DIRECTOR
6641 FULTON AVENUE
Van Nuys CA 91401

Officer/Director/Trustee Four

CARLOS LOVATO
SECRETARY, DIRECTOR
6641 FULTON AVENUE
Van Nuys CA 91401

Organization’s website WWW.SHOSHINKAIKARATE.COM/
Organization’s email SENSEIDERICK@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/24/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 Yes
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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