FORM 1023-EZ for GOOD SAMARITAN HEALTH FOUNDATION
| Field | Data |
|---|---|
| EIN | 84-4768444 |
| Case Number | EO-2020297-000572 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | GOOD SAMARITAN HEALTH FOUNDATION |
| Organization’s Mailing Address | 901 OLIVE DRIVE |
| City | BAKERSFIELD |
| State | CA |
| ZIP | 93308 |
| Accounting period End | 12 |
| Primary contact name | JAGDEEP DILLON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
MANDEEP BAGGA
PRESIDENT AND DIRECTOR
901 OLIVE DRIVE
BAKERSFIELD CA 93308
Officer/Director/Trustee Two
CRAIG BRAUN
CFO AND DIRECTOR
901 OLIVE DRIVE
BAKERSFIELD CA 93308
Officer/Director/Trustee Three
JAGDEEP DILLON
SECRETARY AND DIRECTOR
901 OLIVE DRIVE
BAKERSFIELD CA 93308
| Organization’s website | N/A |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/27/2020 |
| Organization Incorporation State | CA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E70 - Public Health Program (Includes General Health and Wellness Promotion Services) |
| 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 | JAGDEEP DILLON |
| Signature Title | SECRETARY AND DIRECTOR |
| Signature Date | 10/20/2020 |
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