FORM 1023-EZ for DEER HOLLOW FOUNDATION

Field Data
EIN 83-3006687
Case Number EO-2019036-000604
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DEER HOLLOW FOUNDATION
Organization’s Mailing Address 1415 LEAHY DR
City FORT COLLINS
State CO
ZIP 80526-9677
Accounting period End 12
Primary contact name RICHARD JENSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICHARD JENSEN
BOARD MEMBER AND PRESIDENT
1415 LEAHY DRIVE
FORT COLLINS CO 80526-9677

Officer/Director/Trustee Two

RACHEL JENSEN
BOARD MEMBER AND SECRETARY
1415 LEAHY DR
FORT COLLINS CO 80526-9677

Officer/Director/Trustee Three

TAYLOR JENSEN
BOARD MEMBER
1415 LEAHY DR
FORT COLLINS CO 80526-9677

Officer/Director/Trustee Four

BENJAMIN JENSEN
BOARD MEMBER AND TREASURER
1415 LEAHY DR
FORT COLLINS CO 80526-9677

Officer/Director/Trustee Five

AMBER JENSEN
BOARD MEMBER
1415 LEAHY DR
FORT COLLINS CO 80526-9677

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/15/18
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, 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 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 RICHARD JENSEN
Signature Title BOARD MEMBER AND PRESIDENT
Signature Date 1/18/19

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