FORM 1023-EZ for SAM CLOCKER FOUNDATION
| Field | Data |
|---|---|
| EIN | 84-3262808 |
| Case Number | EO-2019280-000348 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | SAM CLOCKER FOUNDATION |
| Organization’s Mailing Address | PO BOX 425 |
| City | RICHMOND |
| State | VT |
| ZIP | 5477-425 |
| Accounting period End | 12 |
| Primary contact name | KENNETH M NUSSBAUM |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
KENNETH NUSSBAUM
PRESIDENT
231 WOLF LANE
RICHMOND VT 5477-7763
Officer/Director/Trustee Two
LISA BERGMAN
SECRETARY
C/O 231 WOLF LANE
RICHMOND VT 5477-7763
Officer/Director/Trustee Three
KENNETH NUSSBAUM
TREASURER
231 WOLF LANE
RICHMOND VT 5477-7763
| Organization’s website | |
|---|---|
| Organization’s email | SAM.CLOCKER@KNUSSBAUM.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/3/19 |
| Organization Incorporation State | VT |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P99 - Human Services - Multipurpose and Other N.E.C. |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes Scientific: Yes Literary: Yes Public Safety: No Amateur Sports: No Cruelty Prevention: Yes |
| 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 | KENNETH NUSSBAUM |
| Signature Title | TREASURER |
| Signature Date | 10/4/19 |
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