FORM 1023-EZ for CHELSEA - COLLABORATIVE HEALTH EDUCATION LABOR SOCIO-ECONOMIC ALLIANCE

Field Data
EIN 81-4175659
Case Number EO-2017178-000158
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHELSEA - COLLABORATIVE HEALTH EDUCATION LABOR SOCIO-ECONOMIC ALLIANCE
Organization’s Mailing Address 1331 GARDEN HIGHWAY
City SACRAMENTO
State CA
ZIP 95833
Accounting period End 12
Primary contact name RONALD HICKEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RONALD HICKEY
PRESIDENT
1331 GARDEN HIGHWAY
SACRAMENTO CA 95661

Officer/Director/Trustee Two

MYESHA LUCAROTTI
SECRETARY
1331 GARDEN HIGHWAY
SACRAMENTO CA 95833

Officer/Director/Trustee Three

TED WILLIAMS
TREASURER
1331 GARDEN HIGHWAY
SACRAMENTO CA 95833

Officer/Director/Trustee Four

ERIC BROWN
CHAIRMAN OF THE BOARD
1331 GARDEN HIGHWAY
SACRAMENTO CA 95833

Officer/Director/Trustee Five

EILEEN CHEN
VICE-CHAIRWOMAN
1331 GARDEN HIGHWAY
SACRAMENTO CA 95833

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/31/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O01 - Alliance/Advocacy Organizations
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 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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