FORM 1023-EZ for KYAS SMILES FOUNDATION

Field Data
EIN 45-2626639
Case Number EO-2016243-000304
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KYAS SMILES FOUNDATION
Organization’s Mailing Address 4900 NE 29TH AVE
City LIGHTHOUSE POINT
State FL
ZIP 33064
Accounting period End 12
Primary contact name KRISTEN KAPUR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAVAN KAPUR
DIRECTOR
4900 NE 29TH AVE
LIGHTHOUSE POINT FL 33064

Officer/Director/Trustee Two

KRISTEN KAPUR
CEO
4900 NE 29TH AVE
LIGHTHOUSE POINT FL 33064

Organization’s website WWW.KYASSMILES.COM
Organization’s email KRISTEN@KYASSMILES.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/5/2012
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H30 - Cancer Research
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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