FORM 1023-EZ for MUSEUM OF CONTEMPORARY ART FLAGSTAFF INC

Field Data
EIN 84-2297658
Case Number EO-2019317-000063
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MUSEUM OF CONTEMPORARY ART FLAGSTAFF INC
Organization’s Mailing Address 555 BLACKBIRD ROOST NUMBER 5
City FLAGSTAFF
State AZ
ZIP 86001
Accounting period End 12
Primary contact name JACQUES CAZAUBON SERONDE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDRES ADAUTO
DIRECTOR/PRESIDENT
324 NORTH KENDRICK STREET
FLAGSTAFF AZ 86001

Officer/Director/Trustee Two

STEPHANIE JACKSON
DIRECTOR/SECRETARY
3218 NORTH GRANDVIEW TRAIL
FLAGSTAFF AZ 86004

Officer/Director/Trustee Three

DAVE FUEGER
DIRECTOR/VICE PRESIDENT
3365 NORTH ESTATES STREET
FLAGSTAFF AZ 86001

Officer/Director/Trustee Four

TRAVIS COUTTS
DIRECTOR/TREASURER
333 WEST OAK AVENUE NUMBER 1
FLAGSTAFF AZ 86001

Officer/Director/Trustee Five

NICHOLAS GEIB
DIRECTOR
1625 NORTH SUNSET DRIVE
FLAGSTAFF AZ 86001

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/3/19
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A26 - Arts Council/Agency
Organization’s purpose Charitable: Yes
Religious: No
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 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 ANDRES ADAUTO
Signature Title DIRECTOR/PRESIDENT
Signature Date 11/11/19

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