FORM 1023-EZ for ACTIVATE LABS

Field Data
EIN 82-2271990
Case Number EO-2017261-000199
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ACTIVATE LABS
Organization’s Mailing Address 12412 GROVEVIEW ST APT D
City GARDEN GROVE
State CA
ZIP 92840
Accounting period End 12
Primary contact name MONICA CURCA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MONICA CURCA
EXECUTIVE DIRECTOR
12412 GROVEVIEW ST APT D
GARDEN GROVE CA 92840

Officer/Director/Trustee Two

JERRY MCCANN
TREASURER
1832 24TH AVENUE
SAN FRANCISCO CA 94122

Officer/Director/Trustee Three

KARA BRUSSOW
CHAIR
26622 ROSEPATH
LAKE FOREST CA 92630

Officer/Director/Trustee Four

JORGE GUZMAN
SECRETARY
39 EAST BELLIS CIRCLE
CAMBRIDGE CA 02140

Organization’s website WWW.ACTIVATELABS.ORG
Organization’s email MONICA@ACTIVATELABS.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/31/2017
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Q40 - International Peace and Security
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
Signature Title
Signature Date

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