FORM 1023-EZ for THE MIKE NIEW FOUNDATION

Field Data
EIN 84-3039168
Case Number EO-2019259-001065
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE MIKE NIEW FOUNDATION
Organization’s Mailing Address 2447 DOUGLAS AVE
City DELRAY BEACH
State FL
ZIP 33444
Accounting period End 12
Primary contact name MICHELE NIEWINSKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHELE NIEWINSKI
DIRECTOR
2447 DOUGLAS AVE
DELRAY BEACH FL 33444

Officer/Director/Trustee Two

JANICE LUCIA
DIRECTOR
15 ROYAL PALM WAY
BOCA RATON FL 33432

Officer/Director/Trustee Three

TODD GERONEMUS
DIRECTOR
1520 SW 19TH ST
BOCA RATON FL 33486

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/10/19
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G30 - Cancer
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TODD GERONEMUS
Signature Title DIRECTOR
Signature Date 9/13/19

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