FORM 1023-EZ for GOLDEN STATE RECUPERATIVE CARE INC

Field Data
EIN 84-3519874
Case Number EO-2021258-000231
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GOLDEN STATE RECUPERATIVE CARE INC
Organization’s Mailing Address 153 E 110TH ST
City LOS ANGELES
State CA
ZIP 90061
Accounting period End 12
Primary contact name EPHREM TILAHUN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EPHREM TILAHUN
PRESIDENT
153 E 110TH ST
LOS ANGELES CA 90061

Officer/Director/Trustee Two

ANTHONY HOLTON
VICE PRESIDENT
153 E 110TH ST
LOS ANGELES CA 90061

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/17/2019
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E50 - Rehabilitative Medical 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 Yes
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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 EPHREM TILAHUN
Signature Title PRESIDENT
Signature Date 9/13/2021

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