FORM 1023-EZ for INLAND EMPIRE SENIOR SERVICES INC

Field Data
EIN 83-0897137
Case Number EO-2018169-000669
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name INLAND EMPIRE SENIOR SERVICES INC
Organization’s Mailing Address PO BOX 8828
City MORENO VALLEY
State CA
ZIP 92552
Accounting period End 12
Primary contact name EARL DOUCETTE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EARL DOUCETTE
CEO
PO BOX 8828
MORENO VALLEY CA 92552

Officer/Director/Trustee Two

SAM ALEKSIC
SECRETARY
12625 FREDERICK ST STE I5-301
MORENO VALLEY CA 92553

Officer/Director/Trustee Three

LETITIA DOUCETTE
CFO
PO BOX 8828
MORENO VALLEY CA 92552

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/29/18
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 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 EARL DOUCETTE
Signature Title CEO
Signature Date 6/14/18

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