FORM 1023-EZ for GROUNDWORK

Field Data
EIN 82-4526989
Case Number EO-2018058-000186
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GROUNDWORK
Organization’s Mailing Address 5280 HOLMES PL
City BOULDER
State CO
ZIP 80303-1244
Accounting period End 12
Primary contact name JEFFREY WAGNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEFFREY WAGNER
EXECUTIVE DIRECTOR
5280 HOLMES PL
BOULDER CO 80303-1244

Officer/Director/Trustee Two

JENNIFER WAGNER
SECRETARY
5280 HOLMES PL
BOULDER CO 80303-1244

Officer/Director/Trustee Three

GREGORY PETTYS
DIRECTOR
16540 GRANGE RD
PAONIA CO 81428-7111

Officer/Director/Trustee Four

RAMPHAI NOIKAEW
DIRECTOR
16540 GRANGE RD
PAONIA CO 81428-7111

Officer/Director/Trustee Five

PARKER PFLAUM
TREASURER
17306 SW 10TH TER
MICANOPY FL 32667-3725

Organization’s website HTTP://WWW.LAYINGGROUNDWORK.ORG
Organization’s email INFO@LAYINGGROUNDWORK.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/15/17
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C60 - Environmental Education and Outdoor Survival Programs
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 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 JEFFREY WAGNER
Signature Title EXECUTIVE DIRECTOR
Signature Date 2/23/18

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