FORM 1023-EZ for FOR UTAH SENIORS INC

Field Data
EIN 82-2711210
Case Number EO-2017310-000252
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FOR UTAH SENIORS INC
Organization’s Mailing Address 3841 W SEAGULL DR
City WEST VALLEY
State UT
ZIP 84120
Accounting period End 12
Primary contact name CONNIE SEGO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CONNIE SEGO
PRESIDENT / TREASURER
3841 W SEAGULL DR
WEST VALLEY UT 84120

Officer/Director/Trustee Two

CHRISTINA APODACA
VICE PRESIDENT
2995 WEST FOREST STREET
BRIGHAM CITY UT 84302

Officer/Director/Trustee Three

ERIKA MERRILL
SECRETARY
650 S MAIN APT 8303
BOUNTIFUL UT 84010

Organization’s website FORUTAHSENIORS.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/26/2017
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P81 - Senior Centers, Services
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 No
Legislation influence No
Compensation of Officer director trustee Yes
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 Yes
One Third Support Gifts No
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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