FORM 1023-EZ for TACKLE CHILDHOOD CANCER INC

Field Data
EIN 85-2525394
Case Number EO-2020234-000089
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TACKLE CHILDHOOD CANCER INC
Organization’s Mailing Address 8029 CAPTAIN DILLON COURT
City SHREVEPORT
State LA
ZIP 71115
Accounting period End 12
Primary contact name KEYVAN SHAHRDAR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEYVAN SHAHRDAR
PSD
8029 CAPTAIN DILLON COURT
SHREVEPORT LA 71115

Officer/Director/Trustee Two

LAURA SHAHRDAR
VP
8029 CAPTAIN DILLON COURT
SHREVEPORT LA 71115

Officer/Director/Trustee Three

GERNINE MAILHES
TR
105 LEO AVENUE
SHREVEPORT LA 71105

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/10/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H30 - Cancer Research
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: Yes
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KEYVAN SHAHRDAR
Signature Title PSD
Signature Date 8/19/2020

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