FORM 1023-EZ for COSMOS INC

Field Data
EIN 83-2052151
Case Number EO-2018297-000316
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COSMOS INC
Organization’s Mailing Address 6887 SADDLEBACK PL
City RANCHO CUCAMONGA
State CA
ZIP 91701
Accounting period End 12
Primary contact name ELENA LARSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK LARSON
CHIEF EXECUTIVE OFFICER
6316 GARNET ST
RANCHO CUCAMONGA CA 91701

Officer/Director/Trustee Two

ELENA LARSON
TREASURER
6887 SADDLEBACK PL
RANCHO CUCAMONGA CA 91701

Officer/Director/Trustee Three

MARK LARSON
CHAIRPERSON OF THE GOVERNING BODY
6316 GARNET ST
RANCHO CUCAMONGA CA 91701

Officer/Director/Trustee Four

ELENA LARSON
DIRECTOR
6887 SADDLEBACK PL
RANCHO CUCAMONGA CA 91701

Officer/Director/Trustee Five

NICHOLAS COLACHIS
DIRECTOR
8896 LOOKOUT MOUNTAIN AVE
LOS ANGELES CA 90046

Organization’s website WWW.COSMOSCORPORATION.US
Organization’s email LARSON.COSMOSCORPORATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/17/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O99 - Youth Development N.E.C.
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 Yes
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 ELENA LARSON
Signature Title DIRECTOR
Signature Date 10/22/18

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