FORM 1023-EZ for CALIFRONIA ASSCOCIATION OF INDEPENDENT NURSES

Field Data
EIN 83-3404601
Case Number EO-2019038-000878
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CALIFRONIA ASSCOCIATION OF INDEPENDENT NURSES
Organization’s Mailing Address 12193 CUSTER ST
City YUCAIPA
State CA
ZIP 92399-4485
Accounting period End 12
Primary contact name RENEE HAMPTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RENEE HAMPTON
PRESIDENT
12193 CUSTER ST
YUCAIPA CA 92399

Officer/Director/Trustee Two

GERI HERNANDEZ
1ST VICE PRESIDENT
1566 HEATHER LANE
RIVERSIDE CA 92405

Officer/Director/Trustee Three

HEIDI GIBSON
2ND VICE PRESIDENT
13654 WILLOW CREEK DR
YUCAIPA CA 92399

Officer/Director/Trustee Four

CONNIE DIAZ
TREASURER
31939 VIA DEL SENOR
HOMELAND CA 92548

Officer/Director/Trustee Five

TINA CARTER
SECRETARY
11950 BERKLEY DR
YUCIAPA CA 92399

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/10/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
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 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 RENEE HAMPTON
Signature Title PRESIDENT
Signature Date 2/3/19

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