FORM 1023-EZ for PINK AND BLUE FOR TWO INC

Field Data
EIN 46-0968877
Case Number EO-2016106-000137
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PINK AND BLUE FOR TWO INC
Organization’s Mailing Address 865 ERNEST DRIVE
City SONOMA
State CA
ZIP 95476
Accounting period End 12
Primary contact name ROBERT SCHAUBLIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT SCHAUBLIN
CEO
1285 SUTTER STREET 305
SAN FRANCISCO CA 94109

Officer/Director/Trustee Two

ROMULO YANES
SECRETARY
195 WALL AVENUE
PATTERSON NJ 07504

Officer/Director/Trustee Three

CHRISTOPHER CARLSEN
TREASURER
8316 MISTY LILAC DRIVE
HUNTERSVILLE CA 28078

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/12/2012
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E20 - Hospitals and Related Primary Medical Care Facilities
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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