FORM 1023-EZ for LENSSHIFT

Field Data
EIN 82-1573559
Case Number EO-2018101-000375
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LENSSHIFT
Organization’s Mailing Address 1831 DELAWARE STREET APT 2C
City BERKELEY
State CA
ZIP 95703
Accounting period End 12
Primary contact name ADITI SHRIVASTAVA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

APARNA SHRIVASTAVA
CHIEF EXECUTIVE OFFICER
13520 SW VILLAGE GLENN DRIVE
TIGARD OR 97223

Officer/Director/Trustee Two

ADITI SHRIVASTAVA
SECRETARY
1831 DELAWARE STREET APT 2C
BERKELEY CA 95703

Officer/Director/Trustee Three

ROURKE HEALEY
CHIEF FINANCIAL OFFICER
416 62ND STREET
OAKLAND CA 94609

Organization’s website WWW.LENSSHIFT.ORG
Organization’s email INFO@LENSSHIFT.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/23/17
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T01 - Alliance/Advocacy Organizations
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 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 APARNA SHRIVASTAVA
Signature Title CHIEF EXECUTIVE OFFICER
Signature Date 4/9/18

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