FORM 1023-EZ for EMILYS LIGHT CYSTIC FIBROSIS FOUNDATION

Field Data
EIN 81-7005756
Case Number EO-2017009-000515
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EMILYS LIGHT CYSTIC FIBROSIS FOUNDATION
Organization’s Mailing Address 17467 LAWRENCE 1030
City WENTWORTH
State MO
ZIP 64873
Accounting period End 12
Primary contact name IAIN BURNETT - TRUSTEE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

IAIN BURNETT
TRUSTEE
1935 REDWOOD DRIVE
HEALDSBURG CA 95448

Officer/Director/Trustee Two

DOUGLAS HANSEN
TRUSTEE
169 CORWIN CIRCLE
HAMPTON VA 23666

Organization’s website EMILYSLIGHT.ORG
Organization’s email
Organization Incorporated
Organization trust Yes
Necessary Organizing Documents Yes
Organization Incorporation Date 12/10/2016
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
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 Yes
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
Signature Title
Signature Date

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