FORM 1023-EZ for COMMUNITY IP MEDIA TELEVISION INC

Field Data
EIN 46-5635311
Case Number EO-2014240-000494
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COMMUNITY IP MEDIA TELEVISION INC
Organization’s Mailing Address 640 BAILEY ROAD SUITE 129
City BAY POINT
State CA
ZIP 94565-4306
Accounting period End 6
Primary contact name SAMUEL GOLD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SAMUEL GOLD
DIRECTOR AND PRESIDENT/CEO
2183 SUGARTREE DRIVE
BAY POINT CA 94565-4421

Officer/Director/Trustee Two

DINA LEE
DIRECTOR AND SECRETARY
640 BAILEY ROAD SUITE 129
BAY POINT CA 94565-4306

Officer/Director/Trustee Three

ROD LAUGHRIDGE
DIRECTOR AND TREASURER
640 BAILEY ROAD SUITE 129
BAY POINT CA 94565-4306

Organization’s website WWW.KIDSRECUEFUND.COM
Organization’s email LEON2K@ME.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/1/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A25 - Arts Education
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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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