FORM 1023-EZ for MODS4QUADS

Field Data
EIN 85-1053363
Case Number EO-2020142-000235
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MODS4QUADS
Organization’s Mailing Address 1104 BLAKE AVE
City GLENWOOD SPRINGS
State CO
ZIP 81601
Accounting period End 12
Primary contact name SUSAN LEETY HORNING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUSAN HORNING
DIRECTOR
1104 BLAKE AVE
GLENWOOD SPRINGS CO 81601

Officer/Director/Trustee Two

ADAM LAVENDER
OFFICER
302 LINDEN CIRCLE
CARBONDALE CO 81623

Officer/Director/Trustee Three

MICHAEL LOWE
TRUSTEE
1912 MIDLAND AVE
GLENWOOD SPRINGS CO 81601

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/15/2020
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative N.E.C.
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 Yes
Donation of funds Yes
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 SUSAN HORNING
Signature Title DIRECTOR
Signature Date 5/19/2020

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