FORM 1023-EZ for AFFIRM CARES

Field Data
EIN 84-2053318
Case Number EO-2019213-000258
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AFFIRM CARES
Organization’s Mailing Address 650 CALIFORNIA STREET 12TH FLOOR
City SAN FRANCISCO
State CA
ZIP 94108-2716
Accounting period End 12
Primary contact name LAURA SANCHEZ-RIVET
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BROOKS HOSFIELD
PRESIDENT
650
SAN FRANCISCO CA 94108-2716

Officer/Director/Trustee Two

JUDE KOMUVES
VICE PRESIDENT
650 CALIFORNIA ST 12TH FLOOR
SAN FRANCISCO CA 94108-2716

Officer/Director/Trustee Three

LAURA SANCHEZ-RIVET
SECRETARY
650 CALIFORNIA ST 12TH FLOOR
SAN FRANCISCO CA 94108-2716

Officer/Director/Trustee Four

SIPHELELE JIYANE
TREASURER
650 CALIFORNIA ST 12TH FLOOR
SAN FRANCISCO CA 94108-2716

Officer/Director/Trustee Five

ULRICO IZAGUIRRE
DIRECTOR
650 CALIFORNIA ST 12TH FLOOR
SAN FRANCISCO CA 94108-2716

Organization’s website N/A
Organization’s email LAURA.SANCHEZ-RIVET@AFFIRM.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/31/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 LAURA SANCHEZ-RIVET
Signature Title SECRETARY
Signature Date 7/30/19

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