FORM 1023-EZ for NORTHERN COLORADO AUTISM ASSOCIATION

Field Data
EIN 81-5419252
Case Number EO-2017093-000280
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NORTHERN COLORADO AUTISM ASSOCIATION
Organization’s Mailing Address 921 PROVINCE ROAD
City FORT COLLINS
State CO
ZIP 80525-9899
Accounting period End 12
Primary contact name PHYLLIS ZIMMERMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PHYLLIS ZIMMERMAN
PRESIDENT
921 PROVINCE ROAD
FORT COLLINS CO 80525-9899

Officer/Director/Trustee Two

TINA BOYER
VICE-PRESIDENT
3012 ROCKBOUGH COURT
FORT COLLINS CO 80525-9899

Officer/Director/Trustee Three

JESSICA GIPSON
SECRETARY
1463 BOX PRARIE CIRCLE
LOVELAND CO 80538-9112

Officer/Director/Trustee Four

META VANSKIEVER
BOARD MEMBER
209 TIMBERWOOD DRIVE
FORT COLLINS CO 80525-9899

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/16/2017
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G84 - Autism
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 Yes
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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