FORM 1023-EZ for IMAGE DE NORTHERN UTAH

Field Data
EIN 87-0572400
Case Number EO-2018135-000462
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name IMAGE DE NORTHERN UTAH
Organization’s Mailing Address PO BOX 1053
City CLEARFIELD
State UT
ZIP 84015
Accounting period End 12
Primary contact name ANNAJANE ARROYO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANNAJANE ARROYO
CHAIR
PO BOX 1053
SUNSET UT 84015

Officer/Director/Trustee Two

HERNANDEZ PAMELA
VICE CHAIR
PO BOX 1053
SUNSET UT 84015

Officer/Director/Trustee Three

ARLENE ANDERSON
SECRETARY
PO BOX 1053
SUNSET UT 84015

Officer/Director/Trustee Four

STEPHANIE WARE
TREASURER
PO
SUNSET UT 84015

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/1/70
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code R20 - Civil Rights, Advocacy for Specific Groups
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 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 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 ANNAJANE ARROYO
Signature Title CHAIR
Signature Date 5/10/18

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