﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" returnVersion="2012v2.1">
  <ReturnHeader binaryAttachmentCount="0">
    <Timestamp>2013-11-15T14:45:44-08:00</Timestamp>
    <TaxPeriodEndDate>2012-12-31</TaxPeriodEndDate>
    <PreparerFirm>
      <EIN>830381077</EIN>
      <PreparerFirmBusinessName>
        <BusinessNameLine1>Timothy J Lilligren CPA</BusinessNameLine1>
      </PreparerFirmBusinessName>
      <PreparerFirmUSAddress>
        <AddressLine1>1001 6th Street Suite 150</AddressLine1>
        <City>Manhattan Beach</City>
        <State>CA</State>
        <ZIPCode>90266</ZIPCode>
      </PreparerFirmUSAddress>
    </PreparerFirm>
    <ReturnType>990EZ</ReturnType>
    <TaxPeriodBeginDate>2012-01-01</TaxPeriodBeginDate>
    <Filer>
      <EIN>954742327</EIN>
      <Name>
        <BusinessNameLine1>TEAM SURVIVOR CALIFORNIA</BusinessNameLine1>
      </Name>
      <NameControl>TEAM</NameControl>
      <USAddress>
        <AddressLine1>1223 WILSHIRE BLVD</AddressLine1>
        <City>SANTA MONICA</City>
        <State>CA</State>
        <ZIPCode>90403</ZIPCode>
      </USAddress>
    </Filer>
    <Officer>
      <Name>KAREN VAN KIRK</Name>
      <Title>PRESIDENT</Title>
      <DateSigned>2013-11-15</DateSigned>
      <AuthorizeThirdParty>true</AuthorizeThirdParty>
    </Officer>
    <Preparer>
      <Name>Timothy J Lilligren CPA</Name>
      <PTIN>P00292338</PTIN>
      <Phone>3107984382</Phone>
      <DatePrepared>2013-11-15</DatePrepared>
      <SelfEmployed>X</SelfEmployed>
    </Preparer>
    <TaxYear>2012</TaxYear>
    <BuildTS>2016-02-25 16:41:14Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCount="5">
    <IRS990EZ documentId="IRS990EZ">
      <MethodOfAccountingCash>X</MethodOfAccountingCash>
      <Organization501c3 referenceDocumentId="990A">X</Organization501c3>
      <GrossReceipts>67195</GrossReceipts>
      <InfoInScheduleOPartI>X</InfoInScheduleOPartI>
      <ContributionsGiftsGrantsEtc>67195</ContributionsGiftsGrantsEtc>
      <TotalRevenue>67195</TotalRevenue>
      <SalariesOtherCompEmplBenefits>13131</SalariesOtherCompEmplBenefits>
      <OtherExpensesTotal>36063</OtherExpensesTotal>
      <TotalExpenses>49194</TotalExpenses>
      <ExcessOrDeficitForYear>18001</ExcessOrDeficitForYear>
      <NetAssetsOrFundBalancesBOY>13523</NetAssetsOrFundBalancesBOY>
      <NetAssetsOrFundBalancesEOY>31524</NetAssetsOrFundBalancesEOY>
      <InfoInScheduleOPartII>X</InfoInScheduleOPartII>
      <CashSavingsAndInvestments>
        <BOY>18556</BOY>
        <EOY>37071</EOY>
      </CashSavingsAndInvestments>
      <LandAndBuildings>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </LandAndBuildings>
      <OtherAssetsTotal>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </OtherAssetsTotal>
      <TotalAssets>
        <BOY>18556</BOY>
        <EOY>37071</EOY>
      </TotalAssets>
      <SumOfTotalLiabilities>
        <BOY>5033</BOY>
        <EOY>5547</EOY>
      </SumOfTotalLiabilities>
      <NetAssetsOrFundBalances>
        <BOY>13523</BOY>
        <EOY>31524</EOY>
      </NetAssetsOrFundBalances>
      <PrimaryExemptPurpose>HEALTH EDUCATION AND FITNESS PROGRAMS</PrimaryExemptPurpose>
      <ProgramServiceAccomplishment>
        <DescriptionProgramServiceAccom>HEALTH EDUCATION AND FITNESS PROGRAMS FOR WOMEN WITH A PAST OF PRESENT DIAGNOSIS OF CANCER</DescriptionProgramServiceAccom>
        <ProgramServiceExpenses>43178</ProgramServiceExpenses>
      </ProgramServiceAccomplishment>
      <TotalProgramServiceExpenses>43178</TotalProgramServiceExpenses>
      <OfficerDirectorTrusteeKeyEmpl>
        <PersonName>KAREN VAN KIRK</PersonName>
        <Title>PRESIDENT</Title>
        <AvgHoursPerWkDevotedToPosition>0.00</AvgHoursPerWkDevotedToPosition>
        <Compensation>0</Compensation>
        <ContriToEmplBenefitPlansEtc>0</ContriToEmplBenefitPlansEtc>
        <ExpenseAccountOtherAllowances>0</ExpenseAccountOtherAllowances>
      </OfficerDirectorTrusteeKeyEmpl>
      <OfficerDirectorTrusteeKeyEmpl>
        <PersonName>JUDY ALEXANDER</PersonName>
        <Title>VICE PRESIDENT</Title>
        <AvgHoursPerWkDevotedToPosition>0.00</AvgHoursPerWkDevotedToPosition>
        <Compensation>0</Compensation>
        <ContriToEmplBenefitPlansEtc>0</ContriToEmplBenefitPlansEtc>
        <ExpenseAccountOtherAllowances>0</ExpenseAccountOtherAllowances>
      </OfficerDirectorTrusteeKeyEmpl>
      <OfficerDirectorTrusteeKeyEmpl>
        <PersonName>CATHERINE WAGAR</PersonName>
        <Title>TREASURER</Title>
        <AvgHoursPerWkDevotedToPosition>0.00</AvgHoursPerWkDevotedToPosition>
        <Compensation>0</Compensation>
        <ContriToEmplBenefitPlansEtc>0</ContriToEmplBenefitPlansEtc>
        <ExpenseAccountOtherAllowances>0</ExpenseAccountOtherAllowances>
      </OfficerDirectorTrusteeKeyEmpl>
      <OfficerDirectorTrusteeKeyEmpl>
        <PersonName>BRUCE RANKIN</PersonName>
        <Title>SECRETARY</Title>
        <AvgHoursPerWkDevotedToPosition>0.00</AvgHoursPerWkDevotedToPosition>
        <Compensation>0</Compensation>
        <ContriToEmplBenefitPlansEtc>0</ContriToEmplBenefitPlansEtc>
        <ExpenseAccountOtherAllowances>0</ExpenseAccountOtherAllowances>
      </OfficerDirectorTrusteeKeyEmpl>
      <ActivitiesNotPreviouslyRpt>false</ActivitiesNotPreviouslyRpt>
      <MadeChangesToOrgnzngEtcDoc>false</MadeChangesToOrgnzngEtcDoc>
      <OrganizationHadUBI>false</OrganizationHadUBI>
      <SubjectToProxyTax>false</SubjectToProxyTax>
      <OrganizationDissolvedEtc>false</OrganizationDissolvedEtc>
      <DidOrgFileForm1120POLThisYear>false</DidOrgFileForm1120POLThisYear>
      <MadeLoansToFromOfficers>true</MadeLoansToFromOfficers>
      <LoansToFromOfficers referenceDocumentId="990L">5000</LoansToFromOfficers>
      <EngagedInExcessBenefitTrans>false</EngagedInExcessBenefitTrans>
      <ProhibitedTaxShelterTrans>false</ProhibitedTaxShelterTrans>
      <StatesWhereCopyOfReturnIsFiled>CA</StatesWhereCopyOfReturnIsFiled>
      <TheBooksAreInCareOf>
        <NamePerson>KAREN VAN KIRK</NamePerson>
        <AddressUS>
          <AddressLine1>1223 WILSHIRE BOVD SUITE 570</AddressLine1>
          <City>SANTA MONICA</City>
          <State>CA</State>
          <ZIPCode>90403</ZIPCode>
        </AddressUS>
        <TelephoneNumber>3107984382</TelephoneNumber>
      </TheBooksAreInCareOf>
      <ForeignFinancialAccount>false</ForeignFinancialAccount>
      <ForeignOffice>false</ForeignOffice>
      <MaintainAnyDonorAdvisedFunds>false</MaintainAnyDonorAdvisedFunds>
      <DoesOrgHaveHospital>false</DoesOrgHaveHospital>
      <TanningServicesProvided>false</TanningServicesProvided>
      <RelatedOrgControlledEntity>false</RelatedOrgControlledEntity>
      <TransactionWithControlEntity>false</TransactionWithControlEntity>
      <EngagePoliticalCmpgnActivities>false</EngagePoliticalCmpgnActivities>
      <EngageInLobbyingActivities>false</EngageInLobbyingActivities>
      <OperatingSchool>false</OperatingSchool>
      <TrnsfrsExemptNonCharRelatedOrg>false</TrnsfrsExemptNonCharRelatedOrg>
      <PartVIOfCompOfHighestPaidEmpl>NONE</PartVIOfCompOfHighestPaidEmpl>
      <PartVIAHghstPaidCntrctProfSer>NONE</PartVIAHghstPaidCntrctProfSer>
      <FiledScheduleA>true</FiledScheduleA>
    </IRS990EZ>
    <IRS990ScheduleA documentId="990A">
      <PubliclySupportedOrg509a2>X</PubliclySupportedOrg509a2>
      <GiftsGrantsContribReceived509>
        <CurrentTaxYearMinus4Years>108712</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>128582</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>96857</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>55576</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>67195</CurrentTaxYear>
        <Total>456922</Total>
      </GiftsGrantsContribReceived509>
      <Total509>
        <CurrentTaxYearMinus4Years>108712</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>128582</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>96857</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>55576</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>67195</CurrentTaxYear>
        <Total>456922</Total>
      </Total509>
      <PublicSupportTotal509>456922</PublicSupportTotal509>
      <GrossInvestmentIncome509>
        <CurrentTaxYearMinus4Years>79</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>69</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>9</CurrentTaxYearMinus2Years>
        <Total>157</Total>
      </GrossInvestmentIncome509>
      <InvestmentIncomeAndUBTI>
        <CurrentTaxYearMinus4Years>79</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>69</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>9</CurrentTaxYearMinus2Years>
        <Total>157</Total>
      </InvestmentIncomeAndUBTI>
      <TotalSupportTotal>
        <CurrentTaxYearMinus4Years>108791</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>128651</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>96866</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>55576</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>67195</CurrentTaxYear>
        <Total>457079</Total>
      </TotalSupportTotal>
      <PublicSupportPercentage509>0.99970</PublicSupportPercentage509>
      <PriorYearSupportPercentage>0.99560</PriorYearSupportPercentage>
      <InvestmentIncomePercentage>0.00030</InvestmentIncomePercentage>
      <ThirtyThreePercntTestsCY509>X</ThirtyThreePercntTestsCY509>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="990B">
      <ContributorInfo>
        <ContributorNumber>RESTRICTED</ContributorNumber>
        <ContributorNameBusiness>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorNameBusiness>
        <ContributorAddressUS>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
      </ContributorInfo>
    </IRS990ScheduleB>
    <IRS990ScheduleL documentId="990L">
      <LoanTable>
        <NamePerson>KAREN VAN KIRK</NamePerson>
        <RelationshipWithOrganization>PRESIDENT</RelationshipWithOrganization>
        <PurposeOfLoan>LOAN FOR OPERATING E</PurposeOfLoan>
        <LoanFromOrganization>X</LoanFromOrganization>
        <OriginalPrincipalAmount>5000</OriginalPrincipalAmount>
        <BalanceDue>5000</BalanceDue>
        <Default>false</Default>
        <ApprovedByBoard>true</ApprovedByBoard>
        <WrittenAgreement>true</WrittenAgreement>
      </LoanTable>
      <TotalBalanceDue>5000</TotalBalanceDue>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="990O">
      <GeneralExplanation>
        <Identifier>O01</Identifier>
        <ReturnReference>Description of other expenses Part I line 16</ReturnReference>
        <Explanation>DESCRIPTION AMOUNT OFFICE 183 INSURANCE 1,534 COMMUNICATIONS 2,075 PAYROLL TAXES 1,720 PAYROLL PROCESSING FEES 505 OTHER PROGRAM EXPENSES 30,046</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>O02</Identifier>
        <ReturnReference>Description of total liabilities Part II line 26</ReturnReference>
        <Explanation>CATEGORY BEGINNING OF YEAR END OF YEAR ACCOUNTS PAYABLE AND ACCRUED E 33 547 LOANS 5,000 5,000</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
  </ReturnData>
</Return>