FORM 1023-EZ for EYE LOVE YOU BACK

Field Data
EIN 84-5066950
Case Number EO-2021103-000879
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EYE LOVE YOU BACK
Organization’s Mailing Address 7248 ACORN GLEN LOOP
City ROSEVILLE
State CA
ZIP 95747
Accounting period End 12
Primary contact name PAUL GOLLENDER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAUL GOLLENDER
PRESIDENT/CEO
407 BRISA RIBERA COURT
ROSEVILLE CA 95747

Officer/Director/Trustee Two

KATHLEEN KENNEDY
TREASURER/CFO
475 EUREKA STREET
SAN FRANCISCO CA 94114

Officer/Director/Trustee Three

KEVIN REEDER
SECRETARY/COO
10800 SCRIPPS RANCH ROAD
SAN DIEGO CA 92131

Organization’s website WWW.EYELOVEYOUBACK.ORG
Organization’s email INFO@EYELOVEYOUBACK.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/16/2020
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G41 - Eye Diseases, Blindness and Vision Impairments
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 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 PAUL GOLLENDER
Signature Title PRESIDENT/CEO
Signature Date 4/6/2021

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