FORM 1023-EZ for FORGET ME NOT GRIEF CENTER OF ALASKA

Field Data
EIN 83-4414667
Case Number EO-2021064-001655
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FORGET ME NOT GRIEF CENTER OF ALASKA
Organization’s Mailing Address 2440 E TUDOR RD BOX 184
City ANCHORAGE
State AK
ZIP 99507
Accounting period End 12
Primary contact name NATHAN T ROGERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NATHAN ROGERS
BOARD SECRETARY/TREASURER
7050 MC LIN CIR
ANCHORAGE AK 99507

Officer/Director/Trustee Two

RENA QUEJA
BOARD PRESIDENT
2300 FOXHALL DR
ANCHORAGE AK 99504

Officer/Director/Trustee Three

JANE BARBER
BOARD VICE PRESIDENT
3601 AKULA DR
ANCHORAGE AK 99516

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/11/2019
Organization Incorporation State AK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name NATHAN ROGERS
Signature Title BOARD SECRETARY/TREASURER
Signature Date 1/12/2021

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