FORM 1023-EZ for AMERICAN INDIAN RELIEF

Field Data
EIN 47-2217984
Case Number EO-2014310-000161
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AMERICAN INDIAN RELIEF
Organization’s Mailing Address 1013 W 575 N
City SPRINGVILLE
State UT
ZIP 84663
Accounting period End 12
Primary contact name NATHAN LARSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JESSICA LARSEN
PRESIDENT/FOUNDER
1013 W 575 N
SPRINGVILLE UT 84663

Officer/Director/Trustee Two

NATHAN LARSEN
DIRECTOR
1013 W 575 N
SPRINGVILLE UT 84663

Officer/Director/Trustee Three

ANDREAH MATHEWS
DIRECTOR
1013 W 575 N
SPRINGVILLE UT 84663

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/1/2014
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P60 - Emergency Assistance (Food, Clothing, Cash)
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 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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