FORM 1023-EZ for LHADRIMA FOUNDATION INC

Field Data
EIN 81-4241303
Case Number EO-2017055-000584
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LHADRIMA FOUNDATION INC
Organization’s Mailing Address 3510 CATALPA WAY
City BOULDER
State CO
ZIP 80304
Accounting period End 12
Primary contact name CYNTHIA MOKU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CYNTHIA MOKU
PRESIDENT, DIRECTOR
3510 CATALPA WAY
BOULDER CO 80304

Officer/Director/Trustee Two

FRED FIALCO
DIRECTOR
PO BOX 4429
BOULDER CO 80306

Officer/Director/Trustee Three

KATHY EMERY
DIRECTOR
3540 CATALPA WAY
BOULDER CO 80304

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/25/2016
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A40 - Visual Arts Organizations
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
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 Yes
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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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