FORM 1023-EZ for HAVE YOU EXPERIENCED JESUS

Field Data
EIN 81-2971225
Case Number EO-2016218-000008
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HAVE YOU EXPERIENCED JESUS
Organization’s Mailing Address 205 N COUNTRY LN
City FRUIT HEIGHTS
State UT
ZIP 84037
Accounting period End 12
Primary contact name DAVID BARTOSIEWICZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID BARTOSIEWICZ
PRESIDENT
205 NORTH COUNTRY LANE
FRUIT HEIGHTS UT 84037

Officer/Director/Trustee Two

RAYMOND ZUKOWSKI
SECRETARY/TREASURER
9206 SOUTH 700 EAST 407
SANDY UT 84070

Officer/Director/Trustee Three

KATHRYN ZUKOWSKI
TRUSTEE
9206 SOUTH 700 EAST 407
SANDY UT 84070

Organization’s website WWW.HAVEYOUEXPERIENCEDJESUS.COM
Organization’s email DVBARTO44@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/17/2016
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X99 - Religion Related, Spiritual Development N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
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
Signature Title
Signature Date

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