FORM 1023-EZ for PETKAUSKAS FOUNDATION

Field Data
EIN 47-2436536
Case Number EO-2014338-000281
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PETKAUSKAS FOUNDATION
Organization’s Mailing Address 3700 ORLEANS AVE APT 5448
City NEW ORLEANS
State LA
ZIP 70119
Accounting period End 12
Primary contact name AUDRIUS PETKAUSKAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

AUDRIUS PETKAUSKAS
PRESIDENT
3700 ORLEASN AVE APT 5448
NEW ORLEANS LA 70119

Officer/Director/Trustee Two

ROMA PETKAUSKAS
VICE PRESIDENT
3700 ORLEANS AVE APT 5448
NEW ORLEANS LA 70119

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/25/2014
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T21 - Corporate Foundations
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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