FORM 1023-EZ for NLH FAMILY FOUNDATION INC

Field Data
EIN 83-3901654
Case Number EO-2019072-000530
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NLH FAMILY FOUNDATION INC
Organization’s Mailing Address 2612 W KENNEDY BLVD
City TAMPA
State FL
ZIP 33609
Accounting period End 12
Primary contact name STEVE WILTSE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEVE WILTSE
DIRECTOR
16643 COUNTY ROAD 672
LITHIA FL 33547

Officer/Director/Trustee Two

ROBERT JUNE
DIRECTOR
22555 CHEROKEE ROSE
LAND O LAKES FL 34639

Officer/Director/Trustee Three

BRANDON ROBERTS
DIRECTOR
112 NORTH 12TH STREET SUITE 1606
TAMPA FL 33602

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/11/19
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
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 STEVE WILTSE
Signature Title DIRECTOR
Signature Date 3/11/19

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