FORM 1023-EZ for ATRIUM SOBER LIVING

Field Data
EIN 81-1601636
Case Number EO-2016076-000217
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ATRIUM SOBER LIVING
Organization’s Mailing Address 30830 CALLE JESSICA
City THOUSAND PALMS
State CA
ZIP 92276
Accounting period End 12
Primary contact name JEFFREY WOLFE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JEFFREY WOLFE
PRESIDENT
30830 CALLE JESSICA
THOUSAND PALMS CA 92276

Officer/Director/Trustee Two

TARA DAVENPORT
TREASURER
60241 ALOE CIRCLE
LA QUINTA CA 92253

Officer/Director/Trustee Three

MICHAEL ZIBELL
SECRETARY
66463 CACTUS DR
DESERT HOT SPRINGS CA 92240

Officer/Director/Trustee Four

RODNEY GONZALEZ
BOARD MEMBER
404 E LAUREL CIRCLE
PALM SPRINGS CA 92262

Organization’s website
Organization’s email PROLOBO1@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/29/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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
Signature Title
Signature Date

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