FORM 1023-EZ for LOST STAR FOUNDATION

Field Data
EIN 87-2031864
Case Number EO-2021267-000325
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LOST STAR FOUNDATION
Organization’s Mailing Address 28 ALBACORE LANE
City BROKEN BOW
State OK
ZIP 74728
Accounting period End 12
Primary contact name DIAN JORDAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DIAN JORDAN
INCORPORATOR
28 ALBACORE LANE
BROKEN BOW OK 74728

Officer/Director/Trustee Two

SHAWN BARFIELD
INCORPORATOR
4510 HAWK OWL DR
NORMAN OK 73072

Officer/Director/Trustee Three

PAUL ANDREW LISTER
INCORPORATOR
3807 TIFFANY CIRCLE
NEWCASTLE OK 73065

Organization’s website
Organization’s email DIJORDAN@YMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/4/2021
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A23 - Cultural, Ethnic Awareness
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 No
Signature Name DIAN JORDAN
Signature Title INCORPORATOR
Signature Date 9/22/2021

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