FORM 1023-EZ for THE STEPHEN ANDREW SMITH FOUNDATIONCO

Field Data
EIN 83-0983126
Case Number EO-2018214-000345
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE STEPHEN ANDREW SMITH FOUNDATIONCO
Organization’s Mailing Address 4495 SOUTH STONE CREEK DRIVE
City WEST HAVEN
State UT
ZIP 84401
Accounting period End 12
Primary contact name ROB SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROB SMITH
DIRECTOR/PRESIDENT
4495 SOUTH STONE CREEK DRIVE
WEST HAVEN UT 84401

Officer/Director/Trustee Two

DUSTIN SMITH
DIRECTOR/VICE-PRESIDENT
2647 WEST 2450 NORTH
FARR WEST UT 84404

Officer/Director/Trustee Three

TRACY VALEIKAS-HIGGS RN
DIRECTOR/TREASURER
144 NORTH DIXIE
LAYTON UT 84041

Officer/Director/Trustee Four

RICHARD SMITH
DIRECTOR
3824 WEST 4550 SOUTH
ROY UT 84067

Officer/Director/Trustee Five

MATTHEW HIGGS
DIRECTOR
144 NORTH DIXIE
LAYTON UT 84041

Organization’s website
Organization’s email ROB4982@ME.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/20/18
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F21 - Alcohol, Drug Abuse, Prevention Only
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 ROB SMITH
Signature Title DIRECTOR/PRESIDENT
Signature Date 7/31/18

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