FORM 1023-EZ for CLEAN WATER SCIENCE NETWORK

Field Data
EIN 82-2292869
Case Number EO-2017230-000099
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CLEAN WATER SCIENCE NETWORK
Organization’s Mailing Address PO BOX 14263
City DURHAM
State NC
ZIP 27709
Accounting period End 12
Primary contact name ANNE MIKELONIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANNE MIKELONIS
PRESIDENT
PO BOX 14263
DURHAM NC 27709

Officer/Director/Trustee Two

FARITH DIAZ
VICE PRESIDENT
PO BOX 14263
DURHAM NC 27709

Officer/Director/Trustee Three

LEWIS ROWLES III
SECRETARY
PO BOX 14263
DURHAM NC 27709

Organization’s website CLEANWATERSCIENCE.ORG
Organization’s email CLEANWATERSCIENCE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/2/2016
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code U20 - Science, General
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: Yes
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 Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
Gaming Activity No
Disaster relief assistance Yes
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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