FORM 1023-EZ for THE FOREST INSTITUTE

Field Data
EIN 37-1845385
Case Number EO-2017114-000166
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE FOREST INSTITUTE
Organization’s Mailing Address 1080 TEVLIN ST
City ALBAN
State CA
ZIP 94706-2467
Accounting period End 12
Primary contact name ROMAN CZEBINIAK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROMAN CZEBINIAK
PRESIDENT CEO
1080 TEVLIN ST
ALBANY CA 94706-2467

Officer/Director/Trustee Two

ORVILLE JACKSON
SECRETARY
1327 CARLOTTA AVE
BERKELEY CA 94703-1003

Officer/Director/Trustee Three

DARIEN SHANSKE
CHIEF FINANCIAL OFFICER
620 D ST
DAVIS CA 95616-3714

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/16/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C30 - Natural Resources Conservation and Protection
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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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