FORM 1023-EZ for FORSA FOUNDATION INC

Field Data
EIN 87-2492323
Case Number EO-2021250-000699
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FORSA FOUNDATION INC
Organization’s Mailing Address 324 INDUSTRIAL PARK RD
City FRANKLIN
State NC
ZIP 28734
Accounting period End 12
Primary contact name JOHN MIRA-KNIPPEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN MIRA-KNIPPEL
CHAIRMAN
324 INDUSTRIAL PARK RD
FRANKLIN NC 28734

Officer/Director/Trustee Two

MICHAEL PIET
SECRETARY
4901 BONNELL AVE
FORT WORTH TX 76107

Officer/Director/Trustee Three

AMY HAMPTON
TREASURER
1442 HARBOUR WALK RD
TAMPA FL 33602

Organization’s website
Organization’s email JMK@FORCAFOUNDATION.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents No
Organization Incorporation Date 9/2/2021
Organization Incorporation State NC
Contains Limitation No
Does not expressly empower No
Contains dissolution No
National Taxonomy of Exempt Entities (NTEE) code T30 - Public 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 Yes
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 Yes
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 No
Signature Name JOHN MIRA-KNIPPEL
Signature Title CHAIRMAN
Signature Date 9/4/2021

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