FORM 1023-EZ for FORMS OF EXPRESSION

Field Data
EIN 84-3302650
Case Number EO-2019288-000556
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FORMS OF EXPRESSION
Organization’s Mailing Address 1976 S LA CIENEGA BLVD SUIT C462
City LOS ANGELES
State CA
ZIP 90034
Accounting period End 12
Primary contact name ARLICE CLEVELAND
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ARLICE CLEVELAND
PRESIDENT
1976 S LA CIENEGA BLVD C462
LOS ANGELES CA 90034

Officer/Director/Trustee Two

JAZMINE WAKEFIELD
SECRETARY
1976 S LA CIENEGA BLVD C462
LOS ANGELES CA 90034

Officer/Director/Trustee Three

AMBER JONES
TREASURE
1976 S LA CIENEGA BLVD C462
LOS ANGELES CA 90034

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/29/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F30 - Mental Health Treatment - Multipurpose and 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 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 ARLICE CLEVELAND
Signature Title PRESIDENT
Signature Date 10/13/19

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