FORM 1023-EZ for HIS FOUNDATION TRUST

Field Data
EIN 47-6362510
Case Number EO-2014294-000188
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HIS FOUNDATION TRUST
Organization’s Mailing Address 13919 S WEST BAY SHORE DR STE G-01
City TRAVERSE CITY
State MI
ZIP 49684-6206
Accounting period End 12
Primary contact name KEITH M NIELSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KEITH NIELSON
TRUSTEE
13919 S WEST BAY SHORE DR STE G-01
TRAVERSE CITY MI 49684-6206

Officer/Director/Trustee Two

CORI NIELSON
TRUSTEE
13919 S WEST BAY SHORE DR STE G-01
TRAVERSE CITY MI 49684-6206

Officer/Director/Trustee Three

JONATHAN CROSBY
TRUSTEE
13919 S WEST BAY SHORE DR STE G-01
TRAVERSE CITY MI 49684-6206

Organization’s website N/A
Organization’s email LINDAO@GENERATIONSMGMT.COM
Organization Incorporated
Organization trust Yes
Necessary Organizing Documents Yes
Organization Incorporation Date 7/15/2014
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T22 - Private Independent Foundations
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
Literary: Yes
Public Safety: Yes
Amateur Sports: Yes
Cruelty Prevention: Yes
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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