FORM 1023-EZ for LOST MOUNTAIN GROUP

Field Data
EIN 86-1308474
Case Number EO-2021078-000798
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LOST MOUNTAIN GROUP
Organization’s Mailing Address 9393 BRIAR LANE
City DELAPLANE
State VA
ZIP 20144
Accounting period End 12
Primary contact name ANDREW KEAHON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDREW KEAHON
PRES/TREASURER/SECRETARY/DIR
9393 BRIAR LANE
DELAPLANE VA 20144

Organization’s website
Organization’s email LOSTMOUNTAINGROUP@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/23/2020
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D60 - Other Services - Specialty Animals
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 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 ANDREW KEAHON
Signature Title PRES/TREASURER/SECRETARY/DIR
Signature Date 1/22/2021

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