FORM 1023-EZ for HEALTH GUARDIANS OF AMERICA

Field Data
EIN 45-4080107
Case Number EO-2015243-000354
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEALTH GUARDIANS OF AMERICA
Organization’s Mailing Address 5817 KILLARNEY CIRCLE
City SAN JOSE
State CA
ZIP 95138
Accounting period End 11
Primary contact name SEONG WON YOUM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SEONG WON YOUM
CHIEF EXECUTIVE OFFICER, DIRECTOR
5817 KILLARNEY CIRCLE
SAN JOSE CA 95138

Officer/Director/Trustee Two

JAY ANDREW BARCELON
CHIEF OPERATING OFFICER
1480 5TH AVENUE
SAN FRANCISCO CA 94122

Officer/Director/Trustee Three

BRIAN KIM
CHIEF FINANCIAL OFFICER (TREASURER)
1111 MARIN AVENUE APT 1
ALBANY CA 94706

Officer/Director/Trustee Four

MATTHEW SUN
CHAIRMAN OF THE BOARD, DIRECTOR
1450 3RD STREET
SAN FRANCISCO CA 94158

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/18/2011
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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