FORM 1023-EZ for ASSOCIATION OF YOUTH SPORTS INJURYPREVENTION

Field Data
EIN 87-1433172
Case Number EO-2021265-000307
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ASSOCIATION OF YOUTH SPORTS INJURYPREVENTION
Organization’s Mailing Address 3775 RUETTE SAN RAPHAEL
City SAN DIEGO
State CA
ZIP 92130
Accounting period End 12
Primary contact name SELENA XIANG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SELENA XIANG
PRESIDENT AND CEO
3775 RUETTE SAN RAPHAEL
SAN DIEGO CA 92130

Officer/Director/Trustee Two

YUYU GONG
CFO
3775 RUETTE SAN RAPHAEL
SAN DIEGO CA 92130

Officer/Director/Trustee Three

REBECCA BRONSTEIN
VICE PRESIDENT
3775 RUETTE SAN RAPHAEL
SAN DIEGO CA 92130

Organization’s website WWW.AYSIP.ORG
Organization’s email INFO@AYSIP.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/4/2021
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
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 No
Correctness Declaration No
Signature Name SELENA XIANG
Signature Title PRESIDENT AND CEO
Signature Date 9/20/2021

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