FORM 1023-EZ for KENYA MOBILE CLINIC

Field Data
EIN 85-1618969
Case Number EO-2020213-000148
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KENYA MOBILE CLINIC
Organization’s Mailing Address 207 SOUTH WESTERN AVE APT 14
City ANAHEIM
State CA
ZIP 92804-1696
Accounting period End 12
Primary contact name JANE CHERRIOKEE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JANE CHERRIOKEE
CHAIRLADY
207
ANAHEIM CA 92804-1696

Officer/Director/Trustee Two

JANE CHERRIOKEE
CHAIRLADY
207 SOUTH WESTERN AVE APT 14
ANAHEIM CA 92804-1696

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/9/2020
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 JANE CHERRIOKEE
Signature Title CHAIRLADY
Signature Date 7/29/2020

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