FORM 1023-EZ for THE LATINO CANCER INSTITUTE

Field Data
EIN 81-2450551
Case Number EO-2018066-000207
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE LATINO CANCER INSTITUTE
Organization’s Mailing Address 123 E SAN CARLOS STE 413
City SAN JOSE
State CA
ZIP 95112
Accounting period End 12
Primary contact name YSABEL DURON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

YSABEL DURON
PRESIDENT, DIRECTOR
278 N 7TH ST
SAN JOSE CA 95112

Officer/Director/Trustee Two

CARMEN LLOMELIN
SECRETARY, DIRECTOR
1200 N NASH ST STE 539
ARLINGTON VA 22209

Officer/Director/Trustee Three

TERESA NINO
TREASURER, DIRECTOR
520 W ELSMERE PL
SAN ANTONIO TX 78212

Organization’s website WWW.LATINOCANCERINSTITUTE.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/21/16
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 YSABEL DURON
Signature Title PRESIDENT, DIRECTOR
Signature Date 3/5/18

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