FORM 1023-EZ for STAGE FREE MELANOMA

Field Data
EIN 82-4933802
Case Number EO-2018106-000857
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STAGE FREE MELANOMA
Organization’s Mailing Address 30443 NAPA STREET
City MENIFEE
State CA
ZIP 92584
Accounting period End 2
Primary contact name ERIC MARTIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERIC MARTIN
CHIEF EXECUTIVE OFFICER
30443 NAPA ST
MENIFEE CA 92584

Officer/Director/Trustee Two

MICHELLE JOHNSON
CHIEF FINANCIAL OFFICER
4769 1/2 NARRAGANSETT
SAN DIEGO CA 92107

Officer/Director/Trustee Three

ARNOLD ABERNATHY
SECRETARY
540 HOLLY LN
PLANTATION FL 33317

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/23/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W01 - Alliance/Advocacy Organizations
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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 ERIC MARTIN
Signature Title CHIEF EXECUTIVE OFFICER
Signature Date 4/3/18

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