FORM 1023-EZ for HILLCREST-MISSION VALLEY LIONS FOUNDATION

Field Data
EIN 47-1790678
Case Number EO-2014258-000299
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HILLCREST-MISSION VALLEY LIONS FOUNDATION
Organization’s Mailing Address 3525 FOURTH AVE
City SAN DIEGO
State CA
ZIP 92103
Accounting period End 6
Primary contact name GREGORY K WILSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KIM FOOTE
PRESIDENT
2038 TETON PASS STREET
EJ CAJON CA 92019

Officer/Director/Trustee Two

ROD MCCLAIN
VICE PRESIDENT
6951 ROCKGLEN AVENUE
SAN DIEGO CA 92111

Officer/Director/Trustee Three

SAM DERUNTZ
SECRETARY
805 MORNING WAY
SAN DIEGO CA 92154

Officer/Director/Trustee Four

HAL TRACY
TREASURER
6264 BRYNWOOD COURT
SAN DIEGO CA 92120

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/27/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support 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 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
Signature Title
Signature Date

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