FORM 1023-EZ for AMIGOS DE JAIBALITO FOUNDATION

Field Data
EIN 47-3787139
Case Number EO-2015205-000529
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AMIGOS DE JAIBALITO FOUNDATION
Organization’s Mailing Address 2938 ROWENA AVENUE
City LOS ANGELES
State CA
ZIP 90039
Accounting period End 12
Primary contact name ALBERT MAGHBOULEH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ALBERT MAGHBOULEH
OFFICER
2938 ROWENA AVENUE
LOS ANGELES CA 90039

Officer/Director/Trustee Two

DERMOT DINAN
OFFICER
3599 IMPERATA DRIVE
ROCKLEDGE FL 32955

Officer/Director/Trustee Three

NADEREH NILFOROUSHAN
OFFICER
2765 MATERA LANE
SAN DIEGO CA 92108

Officer/Director/Trustee Four

ANA MARIA RUSSELL
SECRETARY
PO BOX 526125 GUA 36597
MIAMI FL 33152

Officer/Director/Trustee Five

BERNARD SCHAFER
TREASURER
POSADA JAIBALITO
JAIBALITO, GUATEMELA

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/7/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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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