FORM 1023-EZ for UTAH ASSOCIATION OF OCCUPATIONAL HEALTH NURSES

Field Data
EIN 87-0658266
Case Number EO-2016277-000383
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UTAH ASSOCIATION OF OCCUPATIONAL HEALTH NURSES
Organization’s Mailing Address 1615 LAKEVIEW WAY
City O
State UT
ZIP 84403
Accounting period End 12
Primary contact name KELSIE ANDERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELSIE ANDERSON
PRESIDENT
1615 LAKEVIEW WAY
OGDEN UT 84403

Officer/Director/Trustee Two

SHARON PETERSON
VICE PRESIDENT
277 E MUTTON HOLLOW RD
KAYSVILLE UT 84037

Officer/Director/Trustee Three

KIM KAP
TREASURER
2010 RULON WHITE BLVD
OGDEN UT 84404

Officer/Director/Trustee Four

MICHELLE BAUM
SECRETARY
1034 N 500 W
PROVO UT 84604

Officer/Director/Trustee Five

MICHAEL SANFORD
DIRECTOR
215 S STATE ST STE 700
SALT LAKE CITY UT 84111

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/1/1990
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E90 - Nursing Services (General)
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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