FORM 1023-EZ for MOMENTUM FOUNDATION

Field Data
EIN 84-1974739
Case Number EO-2021089-000065
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOMENTUM FOUNDATION
Organization’s Mailing Address 5244 PESTO WAY
City OAK PARK
State CA
ZIP 91377
Accounting period End 12
Primary contact name DARREN JAFFE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DARREN JAFFE
DIRECTOR
74 ROSEHEDGE LN
OAK PARK CA 91377

Officer/Director/Trustee Two

BRANDON HEIDT
DIRECTOR
5244 PESTO WAY
OAK PARK CA 91377

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/17/2019
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 DARREN JAFFE
Signature Title DIRECTOR
Signature Date 2/9/2021

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