FORM 1023-EZ for BOLD IMPACT

Field Data
EIN 83-3859090
Case Number EO-2019231-000294
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BOLD IMPACT
Organization’s Mailing Address PO BOX 7270
City WOODBRIDGE
State VA
ZIP 22195
Accounting period End 12
Primary contact name SABRINA HERSI ISSA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SABRINA HERSI ISSA
PRESIDENT
PO BOX 7270
WOODBRIDGE VA 22195

Officer/Director/Trustee Two

CHRISTINE LEMIEUX
SECRETARY
11535 WEST 70TH PLACE UNIT B
ARVADA CO 80004

Officer/Director/Trustee Three

SAHRA ABDI
TREASURER
15250 CHINCOTEAGUE CT
WOODBRIDGE VA 22193

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/8/19
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A30 - Media, Communications Organizations
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 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 SABRINA HERSI ISSA
Signature Title PRESIDENT
Signature Date 8/15/19

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