FORM 1023-EZ for DARCY JEDA CORBITT FOUNDATION
| Field | Data |
|---|---|
| EIN | 81-4999870 |
| Case Number | EO-2017142-000434 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | DARCY JEDA CORBITT FOUNDATION |
| Organization’s Mailing Address | PO BOX 942 |
| City | FARGO |
| State | ND |
| ZIP | 58107 |
| Accounting period End | 12 |
| Primary contact name | DARCY CORBITT-HALL |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
DARCY CORBITT-HALL
PRESIDENT/CEO
823 10TH AVENUE N APT 8
FARGO ND 58102
Officer/Director/Trustee Two
MARY BELK
VICE PRESIDENT
205C PEBBLE LN
AIKEN SC 29801
Officer/Director/Trustee Three
ALLISON BOZOVSKY
SECRETARY-TREASURER/CFO
1041 COLLEGE STREET NORTH APT 2
FARGO ND 58102
Officer/Director/Trustee Four
ANNMARIE KAJENCKI
TRUSTEE
803 N 11TH STREET
BISMARCK ND 58501
Officer/Director/Trustee Five
ALYSSA PATTERSON
TRUSTEE
6385 LAKEVIEW COURT
SARALAND AL 36571
| Organization’s website | WWW.DARCYCORBITT.ORG |
|---|---|
| Organization’s email | DJCFUND@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 12/29/2016 |
| Organization Incorporation State | ND |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | R12 - Fund Raising and/or Fund Distribution |
| 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 | Yes |
| Donation of funds | Yes |
| 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 | Yes |
| Benefit of College | No |
| Private Foundation 508(e) | No |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | |
| Signature Title | |
| Signature Date |
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