FORM 1023-EZ for ASOCIACION LATINA DE SERVICIOS DELCSRA INC

Field Data
EIN 54-2190181
Case Number EO-2019227-000096
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ASOCIACION LATINA DE SERVICIOS DELCSRA INC
Organization’s Mailing Address PO BOX 599
City AUGUSTA
State GA
ZIP 30903
Accounting period End 6
Primary contact name VILMA COLON-OLIVER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIAM SALAZAR
PRESIDENT
PO BOX 599
AUGUSTA GA 30903

Officer/Director/Trustee Two

VILMA COLON-OLIVER
VICE PRESIDENT
PO BOX 599
AUGUSTA GA 30903

Officer/Director/Trustee Three

YELITZA MAURA
TREASURER
PO BOX 599
AUGUSTA GA 30903

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/14/05
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E32 - Ambulatory Health Center, Community Clinic
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name VILMA COLON-OLIVER
Signature Title VICE PRESIDENT
Signature Date 8/13/19
EIN 54-2190181
Case Number EO-2019227-000096
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ASOCIACION LATINA DE SERVICIOS DEL CSRA INC
Organization’s Mailing Address PO BOX 599
City AUGUSTA
State GA
ZIP 30903
Accounting period End 6
Primary contact name VILMA COLON-OLIVER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIAM SALAZAR
PRESIDENT
PO BOX 599
AUGUSTA GA 30903

Officer/Director/Trustee Two

VILMA COLON-OLIVER
VICE PRESIDENT
PO BOX 599
AUGUSTA GA 30903

Officer/Director/Trustee Three

YELITZA MAURA
TREASURER
PO BOX 599
AUGUSTA GA 30903

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/14/05
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E32 - Ambulatory Health Center, Community Clinic
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name VILMA COLON-OLIVER
Signature Title VICE PRESIDENT
Signature Date 8/13/19

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