FORM 1023-EZ for KHEMIA ENSEMBLE

Field Data
EIN 86-4002251
Case Number EO-2021152-000818
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KHEMIA ENSEMBLE
Organization’s Mailing Address 372 S 460 W
City SPANISH FORK
State UT
ZIP 84660
Accounting period End 12
Primary contact name SHANE JONES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHANE JONES
DIRECTOR OF PRODUCTION
372 S 460 W
SPANISH FORK UT 84660

Officer/Director/Trustee Two

CHELSEA JONES
DIRECTOR OF OPERATIONS
372 S 460 W
SPANISH FORK UT 84660

Organization’s website WWW.KHEMIAENSEMBLE.COM
Organization’s email LAKHEMIA@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/16/2021
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A6C - Music Groups, Bands, Ensembles
Organization’s purpose Charitable: Yes
Religious: No
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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 SHANE JONES
Signature Title DIRECTOR OF PRODUCTION
Signature Date 5/29/2021

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