FORM 1023-EZ for NICK AND ALLEN FOUNDATION

Field Data
EIN 82-1110509
Case Number EO-2017269-000142
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NICK AND ALLEN FOUNDATION
Organization’s Mailing Address 1307 SHORT COURT
City LOUISVILLE
State CO
ZIP 80027
Accounting period End 12
Primary contact name SUSAN BRUNKHARDT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KUBANAI KALOMBO
PRESIDENT
1307 SHORT COURT
LOUISVILLE CO 80027

Officer/Director/Trustee Two

WES PEAKER
TREASURER
7078 S KNOLLS WAY
CENTENNIAL CO 80122

Officer/Director/Trustee Three

SUSAN BRUNKHARDT
SECRETARY
16433 ALCOTT PLACE
BROOMFIELD CO 80023

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/7/2017
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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