FORM 1023-EZ for WILLING 2 MOVE FORWARD

Field Data
EIN 81-1644616
Case Number EO-2016074-000443
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WILLING 2 MOVE FORWARD
Organization’s Mailing Address 1104 OLIVE AVE
City LONG BEACH
State CA
ZIP 90813
Accounting period End 12
Primary contact name MICHELLE MIRA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MICHELLE MIRA
EXECUTIVE DIRECTOR
1104 OLIVE AVE
LONG BEACH CA 90813

Officer/Director/Trustee Two

DAVID TALBOTT
FINANCIAL OFFICER
2004 S GRAND AVE
SAN PEDRO CA 90731

Officer/Director/Trustee Three

CAROLYN FERGUSON
DIRECTOR
220 E HARCOURT STREET
LONG BEACH CA 90805

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/11/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L41 - Homeless, Temporary Shelter For
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 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 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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