FORM 1023-EZ for ACCESSIBILITY FEEDBACK

Field Data
EIN 82-5329018
Case Number EO-2018128-000793
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ACCESSIBILITY FEEDBACK
Organization’s Mailing Address 3432 DENMARK AVE NUMBER 141
City EAGAN
State MN
ZIP 55123
Accounting period End 12
Primary contact name KEVIN FJELSTED
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEVIN FJELSTED
DIRECTOR
3432 DENMARK AVE NUMBER 141
EAGAN MN 55123

Officer/Director/Trustee Two

SARAH ALAWAMI
DIRECTOR
145 CHATEAU WHISTLER COURT
LAS VEGAS NV 89148

Officer/Director/Trustee Three

MICHAEL MALVER
DIRECTOR
1225 LASALLE AVE 302
MINNEAPOLIS MN 55403

Organization’s website
Organization’s email BOARD@ACCESSIBILITYFEEDBACK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/17/18
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code R23 - Disabled Persons' Rights
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: Yes
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
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 KEVIN FJELSTED
Signature Title DIRECTOR
Signature Date 5/2/18

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