FORM 1023-EZ for COUSINS FOR A CAUSE

Field Data
EIN 46-4087184
Case Number EO-2016217-000281
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COUSINS FOR A CAUSE
Organization’s Mailing Address 7800 SANTA MONICA BLVD - 2ND FLOOR
City WEST HOLLYWOOD
State CA
ZIP 90046
Accounting period End 12
Primary contact name ERIKA HARTOUNIAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SABIN LOMAC
CHIEF EXECUTIVE OFFICER
7800 SANTA MONICA BLVD
WEST HOLLYWOOD CA 90046

Officer/Director/Trustee Two

JAMES TSELIKIS
SECRETARY
7800 SANTA MONICA BLVD
WEST HOLLYWOOD CA 90046

Officer/Director/Trustee Three

ERIKA HARTOUNIAN
ASSISTANT
7800 SANTA MONICA BLVD
WEST HOLLYWOOD CA 90046

Organization’s website
Organization’s email COUSINS4CAUSE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/30/2013
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O11 - Single Organization Support
Organization’s purpose Charitable: Yes
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 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
Signature Title
Signature Date

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