FORM 1023-EZ for MYROCK DIABETES FOUNDATION

Field Data
EIN 46-2526615
Case Number EO-2019242-000262
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MYROCK DIABETES FOUNDATION
Organization’s Mailing Address 3023 BERKELEY AVE UNIT 2
City SHERMAN OAKS
State CA
ZIP 91403
Accounting period End 12
Primary contact name SHAQUANDRA JAMISON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANTHONY ROCK
PRESIDENT
3023 BERKELEY AVE UNIT 2
SHERMAN OAKS CA 91403

Officer/Director/Trustee Two

SHAQUANDRA JAMISON
TREASURER
14625 MAGNOLIA BLVD
SHERMAN OAKS CA 91403

Officer/Director/Trustee Three

SHEENA BATES
SECRETARY
530 BERENDO ST
LOS ANGELES CA 90020

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/22/13
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 SHAQUANDRA JAMISON
Signature Title TREASURER
Signature Date 8/28/19

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