FORM 1023-EZ for A FOUNDATION FOR SELF HEALING INC
| Field | Data |
|---|---|
| EIN | 84-2010546 |
| Case Number | EO-2020265-000637 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | A FOUNDATION FOR SELF HEALING INC |
| Organization’s Mailing Address | 444 N PROSPECT AVE |
| City | REDONDO BEACH |
| State | CA |
| ZIP | 90277 |
| Accounting period End | 12 |
| Primary contact name | DAVIDA PATRICK MOORE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
DAVIDA MOORE
PRESIDENT SECRETARY
444 N PROSPECT AVE
REDONDO BEACH CA 90277
Officer/Director/Trustee Two
STAVROULA BITSAKIS
TREASURE
1096 VIA CORDOVA
SAN PEDRO CA 90732
Officer/Director/Trustee Three
VIKAS JAIN
VICE PRESIDENT
4441 PACIFIC COAST HWY K208
TORRANCE CA 90505
Officer/Director/Trustee Four
BILL HENCKE
BOARD MEMBER
20231 CAPE COTTAGE LN
HUNTINGTON BEACH CA 92646
Officer/Director/Trustee Five
TAKAKO AGUSTSSON
BOARD MEMBER
2515 BLUEMOUND RD
ROLLING HILLS ESTATE CA 90274-2303
| Organization’s website | AFOUNDATIONFORSELFHEALING.ORG |
|---|---|
| Organization’s email | DAVIDA@AFOUNDATIONFORSELFHEALING.ORG |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 5/10/2019 |
| Organization Incorporation State | CA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E60 - Health Support Services |
| 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 | Yes |
| Donation of funds | Yes |
| 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 | DAVIDA MOORE |
| Signature Title | PRESIDENT SECRETARY |
| Signature Date | 9/18/2020 |
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