FORM 1023-EZ for CARA GRACE FOUNDATION INC

Field Data
EIN 81-4427698
Case Number EO-2017006-000129
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CARA GRACE FOUNDATION INC
Organization’s Mailing Address 2629 MANHATTAN AVE UNIT 187
City HERMOSA BEACH
State CA
ZIP 90254
Accounting period End 12
Primary contact name ERICH J ZIELONKA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CARLY WHITE
CEO
2629 MANHATTAN AVE UNIT187
HERMOSA BEACH CA 90254

Officer/Director/Trustee Two

HEATHER WALLACE
DIRECTOR
1449 HOME ROAD
WOODSIDE CA 94062

Officer/Director/Trustee Three

STEPHEN LEFKOVITS
DIRECTOR
1512 PARK AVE
EMERYVILLE CA 94608

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/17/2016
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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