FORM 1023-EZ for ABILITY REVOLUTION INC

Field Data
EIN 82-0850370
Case Number EO-2017086-000599
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ABILITY REVOLUTION INC
Organization’s Mailing Address 1276 TERRA NOVA BLVD
City PACIFICA
State CA
ZIP 94044
Accounting period End 12
Primary contact name JENNIFER CAMOTA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNIFER CAMOTA
PRESIDENT
1276 TERRA NOVA BLVD
PACIFICA CA 94044

Officer/Director/Trustee Two

JENNIFER WONG
SECRETARY
408 STONEYBROOK COURT
DANVILLE CA 94506

Officer/Director/Trustee Three

BOB ALBERT
TREASURER
142 SYLVAN AVE
SAN MATEO CA 94403

Officer/Director/Trustee Four

CHRISTOPHER LUEBKE
DIRECTOR
34864 MISSION BLVD APT119
UNION CITY CA 94587

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/3/2017
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code R23 - Disabled Persons' Rights
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 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
Signature Title
Signature Date

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