FORM 1023-EZ for ACT5- COMMUNITY LIAISON CORP

Field Data
EIN 82-0644864
Case Number EO-2017062-000463
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ACT5- COMMUNITY LIAISON CORP
Organization’s Mailing Address 3281 W 6TH ST
City LOS ANGELES
State CA
ZIP 90020
Accounting period End 12
Primary contact name KALINA NOELLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KALINA NOELLE
DIRECTOR/CEO
1235 W 19TH ST
SAN PEDRO CA 90731

Officer/Director/Trustee Two

ROBERT WILLIAMS
CHIEF FINANCIAL OFFICER/SECRETARY
3333 PIEDMONT AVE NE
ATLANTA GA 30305

Officer/Director/Trustee Three

ANN DOHERTY
TRUSTEE DESIGNEE
1634 DIXON ST
REDONDO BEACH CA 90278

Organization’s website WWW.ACT5.ORG
Organization’s email KNOELLE@ACT5.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/31/2017
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
Literary: Yes
Public Safety: Yes
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
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
Signature Title
Signature Date

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