FORM 1023-EZ for PLAYA VISTA INSTITUTE

Field Data
EIN 83-1607591
Case Number EO-2019182-000267
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PLAYA VISTA INSTITUTE
Organization’s Mailing Address 12481 W FIELDING CIRCLE SUITE 314
City PLAYA VISTA
State CA
ZIP 90094-2940
Accounting period End 12
Primary contact name TERRENCE CONNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARC HUFFMAN
PRESIDENT
12045 E WATERFRONT DRIVE
PLAYA VISTA CA 90094-2940

Officer/Director/Trustee Two

BRUCE SCHELDEN
TREASURER
8128 MANITOBA ST
PLAYA DEL REY CA 90293

Officer/Director/Trustee Three

TERRENCE CONNER
SECRETARY
12481 W FIELDING CIRCLE 314
PLAYA VISTA CA 90094-2940

Officer/Director/Trustee Four

RUTH GALANTER
VICE PRESIDENT
BOX 66494
LOS ANGELES CA 90066

Officer/Director/Trustee Five

DUANE MULLER
VICE PRESIDENT
5826 SEAHORSE COURT
PLAYA VISTA CA 90094-2940

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/3/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A80 - Historical Societies, Related Historical Activities
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 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 TERRENCE CONNER
Signature Title SECRETARY
Signature Date 6/26/19

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