t3-660t70 State of Galifornia Secretary of State Statement of lnformation (Domestic Nonprofit, Credit Union and Consumer Cooperatlve Corporatlons) Filing Fee: $20.00. lf this is an amendment, see instructions. IMPORTANT. READ INSTRUCTIONS BEFORE COMPLETING THIS FORM 1. CORPORAIENAME Community Alcohol and Drug Treatmenl Foundation 15015 Oxnard St. Van Nuys, CA91411-2613 2. CALIFORNIA CORPORATE NUI{BER ,tlll,l c2378629 rlNlNl Gomplete Prlnclpal Offlce Address (Do not abbreviate th€ namo of ihe city. ltem 3 cannot be a P.O. Box.) 3. STREET ADDRESS OF PRINCIPAL OFFICE IN CALIFORNIA. IF 15015 Oxnard 4. St. CITY Van Nuys 4s," CNY MAILING AODRESS OF THE CORPORATION '15015 Oxnard St. lVan Names and Complete Addresses ffhe oG Nuys STATE cA STATE CA ZIP COOE 91411-2613 ZIPCODE 9141 1-2613 corit6ration must list thes€ thre€ ofiicers. A comparabl€ tite for ths specific of{icer may be added: however, the 5. CITY CHIEFEXECUTIVEOFFICER/ Van Nuys Dimitry Ashbel STATE cA ZIP CODE 91411-2324 Van Nuys cA ZIP CODE cnY STATE ZIPCOOE Van Nuys 6, STATE cA CITY SECRETARY Dimitry A.shbel Agent for Serulce of Procesg 91411-2324 91411-2324 'fl;SilXh$ an individual. th€ agenl must reside in California and llern 9 musl be comploted with a California street t:ti 4aaaaaa: address. a P.O. B-A(-;gCdrest ls nol f|i=S lf the agent is another corporation, the agent mu3t have on file with the Calilornia Secretary of Statc a Corporiiiffjirn:::€ode sec{ion 15O5 snd ltorn I mutt b€ left blank. oren6fffiltr Sllr.-'t$nllii::t)..N OF PROCESS IN CALIFORNIA IF AN INONIDUAL CITY STATE cA ZIPCODE 91411-2613 Aot (Califomia Civil Code sec{on 1350, et seq.) is an asrccialion formed to manage a common interest development under lhe Oavis-Slitling Cornrnon lntor€st IJOTE: Corporations formed lo manage a common iilerest developm€nt mu3t also tilo a Statement by Common (Fo.m Sl-ClO) ss r€quir€d by Calilornla Clvil Cod6 section 1363.6, Pleage see inslructions on the reversa side 1I. THE INFOR.i'ATION CONTAINEO HEREIN IS TRUE ANO CORRECT. ou15tm13 OATE Dimitry Ashbel TYPE/PRINTNAME OF P€RSON COMPLETING FORM TITLE ARY OF STATE t?-667736 State of California Secretary of State Statement of lnformation (Domegtic Nonprofit, Credit Union and Consumer Cooperative CorPoratlons) Fllf ng Fes: $20.00. lr Flllng Fee: lzu.uu. lf ruponraftr ,I. tnls is all dlrlengmen\ sse lll:rlrustlfrlls. thls 15 an amendment, see instructlons . READ lNSTRUcTtoNs BEFoRE coMPtETING ;, .-.:i rnts ronrrn ? CORPORATE NAME c2378629 Community Alcohol and Drug Treatment Foundation 15015 Oxnard Street Van Nuys, CA 9141 1 2. CALIFoRNIA CORPORATE C2378629 NUMBER tt ,r ll This Space lor Filing Use Oflly l,l city. ltdfi{lrBrbannot be a P.o. Box.) Complete Principal Offlce Address (Do nol abbreviate tho 3. CITY 15015 Oxnard Street .1. STATE Van Nuys cA STREET ADDRESS OF PRINCIPAL OFFICE IN CALIFORNIA, IF ANY 91411 STATE MAILING ADDRESS OF THE CORPORATION cA 15015 Oxnard Street Names and Complete Addresses of ZIPCOOE ZIP CODE 91411 porporation musl list lhese three ofJicers. A comparable tille for the sp€cifc thE$rF ofiicer may be added; however, lhe preprinted titles ctw STATE Van Nuys cA clw 5. STATE CHIEF EXECUTIVE OFFICER/ Dimitry Ashbel Van Nuys ZIP CODE 91411 cA ZIPCODE 91411 CITY STATE Van Nuys cA ZIP CODE 91411 is an individual, the agent must reside in California and ltem 9 musl b€ completed with a California gtreel lf the agent is another corporation, the agent nlust have on file wilh the California Sectelary of State a section 1505 and ltem certiticale I musl be lefl blank. OF PROCESS IN CALIFORNIA, IF AN 4060 Lynd Ave. ;f;* IilD|VIDUAL CITY Arcadia STATE cA ZIPCODE 91006 t Development Act {Califomia Civil Code seclion 1350, et seq.) Chec* here if the corporalion is an association formed to manage a @mmon interesl developm€nl under the Davis-Slirling Common lnlerest Davis€tirllng t0. n U DevelopmenlAcl. I{OTE: Corporations tormed to managa a common interest development musl also file a Statemenl by Common lnleresl (Foim Sl"ClD) as required by Calafornaa Civil Code section 1363.6, Please see instruclions on lhe reverse side of I1 . THE INFORMATION CONTAINEO HEREIN IS TRUE AND CORRECT. 4116112 Mark Sherman TYPE/PRINTNAME OF PERSON COMPLETING st-100 (REv 01r2012) CFQ/Board Member FORM TITLE BY SECRETARY OF STATE 231 8629 hn'o,F.fkEB"t# olDrShboloditoftla 6W52orz S*6Eyd$e BlllJOllES, ATION Corporation l^aw for chuitable purposQt B. ,, i,: S,-- "t.; The qnific pqposes ofthe C;ffi$gna* to engage in the solicitation, receipr and adminisration of6$ffi4 fmds,.:#d., m 'lle to time disbune such administration ofplolryctfr.and ffi{H prope$y, funds and incOme&ep.&om, toaccomplish one ormore of rhe purposes described i" Sffi. fel6?thihtemal Revenue code of 1986, as amended law). lBw). I \ . froffitp5 t "'.q,,-lq* "n,-irir. ,,s '+":f:' ',:''-.'"i {:li section at any llq :i;.,9::: fuffie federal tax t;t:ii-i:::::i::::iffiq- u. =,ru,; !4#r$ 'i"ir DinityAshbel 8121 VanNrrya Blvd Suite 300 Panorama City, CA 91402 ry. is organized and shallbe operated exclusively forcharitable meaning of Section 501(c)(3) ofthe Internal Revenue Code of 1986. otherprovision ofthese articles of incorporarion, the Corporation to an insubstantial degree, eogage in any activities or exercise any po\vers that are not in firrtherance of the charitable pruposes of the corporatioo, and Corporation shall not take any action or refrain firq6 tqking any action thet would canse the Corporation not to be (t) an orgaoizatiou exempt fiom fderal income ta:r under Section 501(cX3) ofthe Internal Revenue Code of 1986, or @ an organizatisq contribution to which constitute charitable contributions uader Sectiou 170(c)Q) of the lnteraal Revenue Code of 1986. .-, B. No substantial pert of the activities oftbe Crcrporatiou sball consist of carr5ring on Pr-opaganda, or o&erwis-e attemping to influeoce legslq;ipq qrithin Oe neaiing tlre meaning of Sectioa 501(cX3) ofthelnteraal fuvenue Coae anended Aom time ended ftom ti to- time (or conespoqding scction of any firnne law), orcept as .#F# o&errvise Fovidsd in Sectioa 501(h) of the of 1986 as amended fiop time to time (ortbe law), and the Corporation shall sot pqrticipate publishing ordisuib'fi"g of starcments) auy politicai% position to) any candidate for pubUc ofrcq witbiu 501(cX3) of the Interrral Rwe,rue Code of 1986, as amendeil time to time (or the corresponding sntion ofany ex law). oilg#;o fi*hf;.. ":;ry i The pmperty of the Corporation is and the Corporatiou shall not take cause or allow any psrt of&e assff or to the benefit of any director, officer,'o perso& Upoa the dissolution after pa!,,netrt, or provision_=g*ffiffim sh"ll be distributed to one i engagedund op€rated e:(emptstatus truder Seotig"p 501 &omtimeto time (oqfl of. A lne 85 tt lqrhable dei*1$lt to cbaritable purposes, orr&ftain from tal$ng any astion that would eamings oftbe Corporatioo to i.sure or to &e beneEt of any grivate of the Corporatioru rbe assets remairring $b ard liabilities of tbe Corporation dations or eorporatioos which are ioses aail which have established tax- S&Eal Ren'enue Codc of 1986, as amended any firnrre tedeal tax law). for eacbtax yanr a.suchtine and in sucb manrrer on uudisribrned income imposed under Section Code of 1985, as anesded from time to time (or the fth&e feileml tarLaw). shall not engage i:n any act of selfdealing as defined in Section Reveru€ Code of f985, ss ancnded from rime to time (or sectionofany finrc federal tat( law). shall distibute or otbenpise dispose of its holdiogs in any at srcbtime aqd h such mguer as to aot become s$ject to a b"siness holdingp inposed uder Sectiot 4943 of the Intenal Code of 1986, as amendetl from time to ti6e (or tbe correspondiag section ofany fi$ure fcderal ta:< law)D. The Corporation shall not invest aaY emount in such mainer as to cause a tax t'o be i1ps;ed oue the making of such inrresment usder Section 4944 of the Inteztal Revcnue Code of 1986, as arnendeit frrom time to time (or the correspouding section of aayfirtrrre ftderal talr law)- yOOZ%parBq '986IJo erureleg purer{t er$Jo (p)St,6t uoF es q #1ouad:ia alqu: