FORM 1023-EZ for ACHALASIA AWARENESS ORGANIZATION

Field Data
EIN 47-4349387
Case Number EO-2019031-000721
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ACHALASIA AWARENESS ORGANIZATION
Organization’s Mailing Address 11835 DOROTHY STREET APT 8
City LOS ANGELES
State CA
ZIP 90049
Accounting period End 3
Primary contact name NANCY LAZARUS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NANCY LAZARUS
FOUNDER
11835 DOROTHY STREET
LOS ANGELES CA 90049

Officer/Director/Trustee Two

MARTINE LEVEILLE
DIRECTOR
11835 DOROTHY ST APT 8
LOS ANGELES CA 90049

Officer/Director/Trustee Three

KATIE LUNDER
OFFICER
4442 E 121ST WAY
THORNTON CO 80241

Officer/Director/Trustee Four

ANNIE-ROSE WILLIAMS
DIRECTOR OF FUNDRAISING
11835 DOROTHY STREET APT 8
LOS ANGELES CA 90049

Officer/Director/Trustee Five

MEGAN ROSECRANS
CO-FOUNDER
11835 DOROTHY ST APT 8
LOS ANGELES CA 90049

Organization’s website HTTP://ACHALASIAAWARENESS.ORG
Organization’s email INFO@ACHALASIAAWARENESS.ORG
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/7/14
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name NANCY LAZARUS
Signature Title FOUNDER
Signature Date 1/5/19
EIN 47-4349387
Case Number EO-2015329-000228
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ACHALASIA AWARENESS ORGANIZATION
Organization’s Mailing Address 11835 DOROTHY STREET 8
City LOS ANGELES
State CA
ZIP 90049-5487
Accounting period End 3
Primary contact name NANCY LAZARUS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NANCY LAZARUS
FOUNDER
11835 DOROTHY STREET 8
LOS ANGELES CA 90049-5487

Officer/Director/Trustee Two

MEGAN ROSECRANS
CO-FOUNDER
9008 STEELE CANYON RD
NAPA CA 94558-9638

Officer/Director/Trustee Three

KERRY MCINTIRE SANDELL
DIRECTOR
2213 BROOKFIELD DRIVE
BRENTWOOD TN 37027-3713

Officer/Director/Trustee Four

MARTINE LEVEILLE
OFFICER
11835 DOROTHY STREET 8
LOS ANGELES CA 90049-5487

Officer/Director/Trustee Five

KATHLEEN CHANDLER
SECRETARY
502 STEPNEY COURT SE
MARIETTA GA 30067-2719

Organization’s website HTTP://ACHALASIAAWARENESS.ORG
Organization’s email INFO@ACHALASIAAWARENESS.ORG
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/7/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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
Signature Title
Signature Date

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