FORM 1023-EZ for POMONA IMPACT FOUNDATION

Field Data
EIN 81-2867074
Case Number EO-2016243-000181
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name POMONA IMPACT FOUNDATION
Organization’s Mailing Address 2678 NW 23RD WAY
City BOCA RATON
State FL
ZIP 33431-4017
Accounting period End 12
Primary contact name RICHARD AMBROSE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICHARD AMBROSE
DIRECTOR
2678 NW 23RD WAY
BOCA RATON FL 33431-4017

Officer/Director/Trustee Two

SARAH STERLING
DIRECTOR
2678 NW 23RD WAY
BOCA RATON FL 33431-4017

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/2016
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T22 - Private Independent Foundations
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 Yes
Donation of funds No
Conducting Activities Outside of United States Yes
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
Signature Title
Signature Date

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