FORM 1023-EZ for 5280 IMPACT

Field Data
EIN 47-4009215
Case Number EO-2015147-000071
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name 5280 IMPACT
Organization’s Mailing Address 7637 W BROOK DRIVE
City LITTLETON
State CO
ZIP 80128
Accounting period End 12
Primary contact name MELISSA RAE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MELISSA RAE
DIRECTOR
7637 W BROOK DRIVE
LITTLETON CO 80128

Organization’s website
Organization’s email 5280IMPACT@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/25/2015
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P12 - Fund Raising and/or Fund Distribution
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 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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