FORM 1023-EZ for THE PAY IT FORWARD MOVEMENT

Field Data
EIN 81-1231483
Case Number EO-2016029-000275
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE PAY IT FORWARD MOVEMENT
Organization’s Mailing Address 6008 BIXBY VILLAGE DR UNIT 31
City LONG BEACH
State CA
ZIP 90803
Accounting period End 12
Primary contact name FRAN TOKAHUTA-DIAZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

FRAN TOKAHUTA-DIAZ
PRESIDENT
6008 BIXBY VILLAGE DRIVE UNIT 31
LONG BEACH CA 90803

Officer/Director/Trustee Two

KRISTOPHER MCGOWEN
TREASURER
6028 BIXBY VILLAGE DRIVE UNI T81
LONG BEACH CA 90803

Officer/Director/Trustee Three

KERRI CUTFORTH
VICE PRESIDENT AND SECRETARY
2706 FAIRMAN STREET
LAKEWOOD CA 90712

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P12 - Fund Raising and/or Fund Distribution
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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