FORM 1023-EZ for CLUB LUZ DE AMERICA

Field Data
EIN 83-0850719
Case Number EO-2018164-000230
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CLUB LUZ DE AMERICA
Organization’s Mailing Address 1406 ALHAMBRA RD
City SOUTH PASADENA
State CA
ZIP 91030
Accounting period End 12
Primary contact name MIRIAM BURBANO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GABRIELA CAIZACHANA
PRESIDENT
8419 70TH ST
PARAMOUNT CA 90723

Officer/Director/Trustee Two

GABRIEL ZAMBRANO
VICEPRESIDENT
5625 SANTA ANITA AVE - 210
TEMPLE CITY CA 91780

Officer/Director/Trustee Three

SANDRA ALVARADO
TREASURER
17202 INGLEWOOD AVE - 111
LAWNDALE CA 90260

Officer/Director/Trustee Four

ALEJANDRO X TOSCANO
SECRETARY
17202 INGLEWOOD AVE - 111
LAWNDALE CA 90260

Officer/Director/Trustee Five

MIRIAM BURBANO
GENERAL COORDINATOR
1406 ALHAMBRA RD
SOUTH PASADENA CA 91030

Organization’s website
Organization’s email MSBURBANO@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/16/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name MIRIAM BURBANO
Signature Title GENERAL COORDINATOR
Signature Date 6/11/18

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