FORM 1023-EZ for GODS SECRET SERVICE AGENTS FOUNDATION

Field Data
EIN 46-2346444
Case Number EO-2015175-000216
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GODS SECRET SERVICE AGENTS FOUNDATION
Organization’s Mailing Address 1422 W KEY HARBOR DR
City GILBERT
State AZ
ZIP 85233-7838
Accounting period End 12
Primary contact name VIVIEN LATTIBEAUDIERE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

VIVIEN LATTIBEAUDIERE
DIRECTOR AND PRESIDENT/CEO
1422 W KEY HARBOR DR
GILBERT AZ 85233-7838

Officer/Director/Trustee Two

DERRICK LATTIBEAUDIERE
TREASURER/CFO
1422 W KEY HARBOR DR
GILBERT AZ 85233-7838

Officer/Director/Trustee Three

BARB DOMKE
DIRECTOR AND VICE-PRESIDENT
3904 E PALMER ST
GILBERT AZ 85298-8856

Officer/Director/Trustee Four

DEBORAH BATES
DIRECTOR
1421 W KEY HARBOR DR
GILBERT AZ 85233-7839

Officer/Director/Trustee Five

KARRINA DOMKE
SECRETARY
3904 E PALMER ST
GILBERT AZ 85298-8856

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/16/2013
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other 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 Yes
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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