FORM 1023-EZ for ROS1DERS INC

Field Data
EIN 83-4490547
Case Number EO-2019129-000332
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROS1DERS INC
Organization’s Mailing Address 1945 GOLDEN WAY
City MOUNTAIN VIEW
State CA
ZIP 94040
Accounting period End 12
Primary contact name ERIC GOLDMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LISA GOLDMAN
PRESIDENT/DIRECTOR
1945 GOLDEN WAY
MOUNTAIN VIEW CA 94040

Officer/Director/Trustee Two

JANET FREEMAN-DAILY
VICE PRESIDENT/DIRECTOR
3512 SW 310TH CT
FEDERAL WAY WA 98023

Officer/Director/Trustee Three

TORI TOMALIA
VICE PRESIDENT/DIRECTOR
2657 MAPLEWOOD AVE
ANN ARBOR MI 48104

Officer/Director/Trustee Four

ERIC GOLDMAN
SECRETARY/CFO
1945 GOLDEN WAY
MOUNTAIN VIEW CA 94040

Organization’s website HTTPS://ROS1CANCER.COM
Organization’s email EGOLDMAN@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/8/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H99 - Medical Research N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 ERIC GOLDMAN
Signature Title SECRETARY/CFO
Signature Date 5/7/19

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