FORM 1023-EZ for NANOFASA USA INCORPORATED

Field Data
EIN 81-4640893
Case Number EO-2017142-000362
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NANOFASA USA INCORPORATED
Organization’s Mailing Address 671 IRVINE RANCH ROAD
City POINCIANA
State FL
ZIP 34759
Accounting period End 12
Primary contact name DR HAROLD G JEFFCOAT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HAROLD JEFFCOAT
DIRECTOR
671 IRVINE RANCH ROAD
POINCIANA FL 34759

Officer/Director/Trustee Two

ALEKSANDRA ORBECK-NILSSEN
PRESIDENT AND DIRECTOR
671 IRVINE RANCH ROAD
POINCIANA FL 34759

Officer/Director/Trustee Three

AASMUND ORBECK-NILSSEN
SECRETARY AND DIRECTOR
671 IRVINE RANCH ROAD
POINCIANA FL 34759

Officer/Director/Trustee Four

ANNE-KARINA HAGELUND
DIRECTOR
671 IRVINE RANCH ROAD
POINCIANA FL 34759

Officer/Director/Trustee Five

ELISE MEREKOLL MIDDLETON
DIRECTOR
6
POINCIANA FL 34759

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/7/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C12 - Fund Raising and/or Fund Distribution
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 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 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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