FORM 1023-EZ for THE ROTARY DISTRICT 5340 FOUNDATION

Field Data
EIN 47-4328240
Case Number EO-2016117-000062
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE ROTARY DISTRICT 5340 FOUNDATION
Organization’s Mailing Address 15373 INNOVATION DRIVE SUITE 385
City SAN DIEGO
State CA
ZIP 92128
Accounting period End 12
Primary contact name JAMES ROTH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LOUISE ANDRES
DIRECTOR PRESIDENT
15373 INNOVATION DRIVE
SAN DIEGO CA 92128

Officer/Director/Trustee Two

RICHARD STEVENS
DIRECTOR TREASURER
15373 INNOVATION DRIVE
SAN DIEGO CA 92128

Officer/Director/Trustee Three

JAMES ROTH
DIRECTOR SECRETARY
15373 INNOVATION DRIVE
SAN DIEGO CA 92128

Organization’s website
Organization’s email JROTH@THEROTHLAWFIRM.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/13/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M12 - Fund Raising and/or Fund Distribution
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 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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