FORM 1023-EZ for REGIS FAMILY SERVICE AGENCY & RESIDENTIAL CARE FACILITY INC

Field Data
EIN 85-2579782
Case Number EO-2021152-000386
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name REGIS FAMILY SERVICE AGENCY & RESIDENTIAL CARE FACILITY INC
Organization’s Mailing Address 905 W POPLAR STREET
City COMPTON
State CA
ZIP 90220
Accounting period End 12
Primary contact name LAVERNE WILSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAVERNE WILSON
PRESIDENT & DIRECTOR
1411 S RIMPAU SUITE 114
CORONA CA 92879

Officer/Director/Trustee Two

CHARLES SMITH
TREASURER & DIRECTOR
1411 S RIMPAU SUITE 114
CORONA CA 92879

Officer/Director/Trustee Three

TYSHEA ROGERS
SECRETARY & DIRECTOR
1411 S RIMPAU SUITE 114
CORONA CA 92879

Organization’s website
Organization’s email REGISFAMILYSERVICES15@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/10/2020
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family 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 No
Donation of funds Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name LAVERNE WILSON
Signature Title PRESIDENT & DIRECTOR
Signature Date 5/27/2021

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