FORM 1023-EZ for CANOGA PARK SENIOR CITIZENS CLUB

Field Data
EIN 80-0653543
Case Number EO-2017009-000230
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CANOGA PARK SENIOR CITIZENS CLUB
Organization’s Mailing Address 7326 JORDAN AVENUE
City CANOGA PARK
State CA
ZIP 91303
Accounting period End 12
Primary contact name EDWARD KENT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VIRGINIA ATHEY
PRESIDENT
7326 JORDAN AVENUE
CANOGA PARK CA 91303

Officer/Director/Trustee Two

LORRY REEVES
VICE-PRESIDENT
7326 JORDAN AVENUE
CANOGA PARK CA 91303

Officer/Director/Trustee Three

LOIS ROCHETTI
TREASURER
7326 JORDAN AVENUE
CANOGA PARK CA 91303

Officer/Director/Trustee Four

ALTA KOUTNIK
SECRETARY
7326 JORDAN AVENUE
CANOGA PARK CA 91303

Officer/Director/Trustee Five

VIVIAN JOHNSON
MEMBERSHIP
7326 JORDAN AVENUE
CANOGA PARK CA 91303

Organization’s website N/A
Organization’s email EDKENTLAW@ATT.NET
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/26/2010
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P81 - Senior Centers, Services
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 Yes
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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