FORM 1023-EZ for GRACE JOHANSEN MEMORIAL FOUNDATION
| Field | Data |
|---|---|
| EIN | 84-3130969 |
| Case Number | EO-2020104-000436 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | GRACE JOHANSEN MEMORIAL FOUNDATION |
| Organization’s Mailing Address | 1181 DAHLIA RD |
| City | LIVINGSTON MANOR |
| State | NY |
| ZIP | 12758-8814 |
| Accounting period End | 8 |
| Primary contact name | LEIF KENNETH JOHANSEN |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
LEIF JOHANSEN
PRESIDENT
1181 DAHLIA RD
LIVINGSTON MANOR NY 12758-8814
Officer/Director/Trustee Two
SOMMER JOHANSEN
VICE PRESIDENT
313 LA VIDA WAY
DAVIS CA 95618-4327
Officer/Director/Trustee Three
PEGGY JOHANSEN
SECRETARY
22 SPRING STREET
LIVINGSTON MANOR NY 12758-8814
Officer/Director/Trustee Four
JEFFREY MICHEL
BOARD MEMBER
360 LAIRD RD
SWAN LAKE NY 12783-5613
| Organization’s website | |
|---|---|
| Organization’s email | GRACEJOHANSENFOUNDATION@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 8/28/2019 |
| Organization Incorporation State | NY |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | O12 - Fund Raising and/or Fund Distribution |
| 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 | 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 | LEIF JOHANSEN |
| Signature Title | PRESIDENT |
| Signature Date | 4/11/2020 |
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