FORM 1023-EZ for IOWA ENDODONTIC FOUNDATION
| Field | Data |
|---|---|
| EIN | 83-1191937 |
| Case Number | EO-2018218-000162 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | IOWA ENDODONTIC FOUNDATION |
| Organization’s Mailing Address | 4335 PIONEER TRAIL SE |
| City | CEDAR RAPIDS |
| State | IA |
| ZIP | 52403 |
| Accounting period End | 12 |
| Primary contact name | MARK VAN HEUKELOM |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
DR THOMAS L PEEK
PRESIDENT AND DIRECTOR
4335 PIONEER TRAIL SE
CEDAR RAPIDS IA 52403
Officer/Director/Trustee Two
JUDITH H PEEK
DIRECTOR
4335 PIONEER TRAIL SE
CEDAR RAPIDS IA 52403
Officer/Director/Trustee Three
DR DEREK T PEEK
DIRECTOR
2929 CENTER POINT ROAD NE
CEDAR RAPIDS IA 52402
Officer/Director/Trustee Four
DR DAVID C GEHRING
DIRECTOR
5012 CENTER POINT ROAD NE
CEDAR RAPIDS IA 52402
Officer/Director/Trustee Five
DR CHRIS TYLER
DIRECTOR
1601 BOYSON SQUARE DR
HIAWATHA IA 52233
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 7/11/18 |
| Organization Incorporation State | IA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E80 - Health, General and Financing |
| 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 | Yes |
| 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 | DR THOMAS L PEEK |
| Signature Title | PRESIDENT AND DIRECTOR |
| Signature Date | 8/1/18 |
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