FORM 1023-EZ for LA HABRA COLLABORATIVE

Field Data
EIN 47-2082315
Case Number EO-2014328-000229
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LA HABRA COLLABORATIVE
Organization’s Mailing Address 151 EAST WHITTIER BOULEVARD SUITE F
City LA HABRA
State CA
ZIP 90631
Accounting period End 12
Primary contact name BARRY ROSS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SANDI BALTIS
EXECUTIVE DIRECTOR
1014 LOCKHAVEN DRIVE
BREA CA 92821

Officer/Director/Trustee Two

ELAINE FRIESEN
TREASURER
222 NORTH EUCLID AVENUE
LA HABRA CA 90631

Officer/Director/Trustee Three

BARRY ROSS
CHAIRPERSON
101 EAST VALENCIA MESA DRIVE
FULLERTON CA 92835

Officer/Director/Trustee Four

CARRIE SURICH
SECRETARY
2000 WEST ELMCROFT CIRCLE
LA HABRA CA 90631

Officer/Director/Trustee Five

REBECCA FRENCH
VICE CHAIR
1031 WEST WHITTIER BOULEVARD
LA HABRA CA 92831

Organization’s website HTTP://WWW.LHCOLLAB.ORG/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/29/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S21 - Community Coalitions
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 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 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
Signature Title
Signature Date

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