FORM 1023-EZ for SOUL MEDICINE

Field Data
EIN 83-2106969
Case Number EO-2018282-000128
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUL MEDICINE
Organization’s Mailing Address 4110 SOUTH HAMPTON CIRCLE
City BOULDER
State CO
ZIP 80301-6010
Accounting period End 12
Primary contact name SURENDRA SHRESTHA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SURENDRA SHRESTHA
PRESIDENT
4110 SOUTH HAMPTON CIRCLE
BOULDER CO 80301-6010

Officer/Director/Trustee Two

JULIA ABRAMOVA
SECRETARY
4110 SOUTH HAMPTON CIRCLE
BOULDER CO 80301-6010

Officer/Director/Trustee Three

MARTIN CHURCH
TREASURER
4110 SOUTH HAMPTON CIRCLE
BOULDER CO 80301-6010

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/3/18
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A99 - Arts, Culture, and Humanities N.E.C.
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SURENDRA SHRESTHA
Signature Title PRESIDENT
Signature Date 10/3/18

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