FORM 1023-EZ for SAMO MASTERS-SWIM HABIT

Field Data
EIN 47-1294984
Case Number EO-2014324-000238
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SAMO MASTERS-SWIM HABIT
Organization’s Mailing Address 1030 20TH STREET APT 6
City SANTA MONICA
State CA
ZIP 90403
Accounting period End 12
Primary contact name LILIANA AVELAR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LILIANA AVELAR
DIRECTOR PRESIDENT
1030 20TH STREET APT 6
Santa Monica CA 90403

Officer/Director/Trustee Two

CORINNE DEORSAY
TREASURER SECRETARY, DIRECTOR
1030 20TH STREET APT 6
SANTA MONICA CA 90403

Officer/Director/Trustee Three

IMAN KHADEMBASHI
DIRECTOR
1030 20TH STREET APT 6
Santa Monica CA 90403

Organization’s website WWW.SWIMSANTAMONICA.COM
Organization’s email LILIAVELAR@HOTMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/26/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N67 - Swimming, Water Recreation
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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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