FORM 1023-EZ for MILES JEFFREY ROBERTS FOUNDATION

Field Data
EIN 84-2912363
Case Number EO-2019295-000199
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MILES JEFFREY ROBERTS FOUNDATION
Organization’s Mailing Address 2632 WAYSIDE DRIVE
City ANN ARBOR
State MI
ZIP 48103
Accounting period End 7
Primary contact name KRISTEN ROBERTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDREA EISMAN
PRESIDENT
4047 RAMSGATE COURT
ANN ARBOR MI 48103-6301

Officer/Director/Trustee Two

KRISTEN ROBERTS
SECRETARY/EXECUTIVE DIRECTOR
2632 WAYSIDE DRIVE
ANN ARBOR MI 48103-2276

Officer/Director/Trustee Three

ANDREW WRIGHT
TREASURER
1235 SEVERN COURT
ANN ARBOR MI 48105-2863

Officer/Director/Trustee Four

LIZ MARE
FUNDRAISING CHAIR
3877 DELHI OVERLOOK STREET
ANN ARBOR MI 48103-9486

Officer/Director/Trustee Five

JEFFREY ROBERTS
OPERATIONS MANAGER
2632 WAYSIDE DRIVE
ANN ARBOR MI 48103-2276

Organization’s website MILESROBERTS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/21/19
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
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 Yes
Signature Name KRISTEN ROBERTS
Signature Title SECRETARY/EXECUTIVE DIRECTOR
Signature Date 10/20/19

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