FORM 1023-EZ for LEAP MEDICINE FOUNDATION

Field Data
EIN 46-5290650
Case Number EO-2014303-000107
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LEAP MEDICINE FOUNDATION
Organization’s Mailing Address 1135 KILDAIRE FARM RD
City CARY
State NC
ZIP 27511
Accounting period End 4
Primary contact name CHRISTOPHER JOHNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHRISTOPHER JOHNSON
EXECUTIVE DIRECTOR
305 KILDAIRE FARM RD STE 200
CARY NC 27511

Officer/Director/Trustee Two

DAVID NATHANSON
BOARD MEMBER
1900 MCKINNON
DALLAS TX 75201

Officer/Director/Trustee Three

LESA HARTWIG-WILLIAMS
BOARD MEMBER
810 HAPPY CREEK LANE
WEST CHESTER PA 19380

Officer/Director/Trustee Five

JANICE PARK
BOARD MEMBER
1615 VANCE AVENUE
WEST CHESTER PA 19380

Organization’s website HTTP://WWW.LEAPMEDFOUNDATION.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/10/2014
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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
Signature Title
Signature Date

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