FORM 1023-EZ for HOUSE OF BROKEN COOKIES

Field Data
EIN 82-5376973
Case Number EO-2018169-000889
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HOUSE OF BROKEN COOKIES
Organization’s Mailing Address 122
City LOS ALAMITOS
State CA
ZIP 90720-122
Accounting period End 12
Primary contact name JENNIFER BALLINGER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNIFER BALLINGER
CEO
PO BOX 122
LOS ALAMITOS CA 90720-122

Officer/Director/Trustee Two

CAROL BALLINGER
TREASUER
PO BOX 122
LOS ALAMITOS CA 90720-122

Officer/Director/Trustee Three

JUDY FOSTER
SECRETARY
3788 CONQUISTA AVE
LONG BEACH CA 90808-2211

Organization’s website HTTP://HOUSEOFBROKENCOOKIES.COM/
Organization’s email HOUSEOFBROKENCOOKIES@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/12/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
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 JENNIFER BALLINGER
Signature Title CEO
Signature Date 6/16/18

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