FORM 1023-EZ for HEADS UP CRANIOFACIAL SURGERY FOUNDATION
| Field | Data |
|---|---|
| EIN | 85-3544832 |
| Case Number | EO-2020303-000400 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | HEADS UP CRANIOFACIAL SURGERY FOUNDATION |
| Organization’s Mailing Address | 390 HARDSCRABBLE RD |
| City | MORGAN |
| State | UT |
| ZIP | 84050 |
| Accounting period End | 9 |
| Primary contact name | BRIAN HORNE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
GRANT FAIRBANKS
PRESIDENT
390 HARDSCRABBLE RD
MORGAN UT 84050
Officer/Director/Trustee Two
BRIAN HORNE
DIRECTOR AND OFFICER
1398 S 600 W
WOODS CROSS UT 84010
Officer/Director/Trustee Three
MICHELLE JACOBI
DIRECTOR AND SECRETARY
325 N 3425 W
LAYTON UT 84041
Officer/Director/Trustee Four
PAUL FAIRBANKS
DIRECTOR
3504 ASHMORE LN
PACE FL 32571
Officer/Director/Trustee Five
CHRISTOPHER BECKREST
DIRECTOR AND OFFICER
1540 W 925 S
SYRACUSE UT 84075
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/20/2020 |
| Organization Incorporation State | UT |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | G9B - Surgery |
| 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 | No |
| One Third Support Gifts | No |
| Benefit of College | No |
| Private Foundation 508(e) | Yes |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | GRANT FAIRBANKS |
| Signature Title | PRESIDENT |
| Signature Date | 10/27/2020 |
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