FORM 1023-EZ for CARBALLO INTERNATIONAL

Field Data
EIN 81-4525763
Case Number EO-2016336-000437
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CARBALLO INTERNATIONAL
Organization’s Mailing Address 4527 LYNDENWOOD PT
City HIGHLANDS RANCH
State CO
ZIP 80130
Accounting period End 12
Primary contact name ALEX HALPERN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

FABRICIO CARBALLO
PRESIDENT; DIRECTOR
4527 LYNDENWOOD PT
HIGHLANDS RANCH CO 80130

Officer/Director/Trustee Two

SACHA CARBALLO
SECRETARY; DIRECTOR
4527 LYNDENWOOD PT
HIGHLANDS RANCH CO 80130

Officer/Director/Trustee Three

LEOBARDO REYES
DIRECTOR
3882 S EVANSTON
AURORA CO 80014

Officer/Director/Trustee Four

JORGE VILLALOBOS CARBALLO
DIRECTOR
6637 S GALLUP ST
LITTLETON CO 80120

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/28/2016
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 Yes
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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