FORM 1023-EZ for PERRY JOHNSON CHARITABLE FOUNDATION

Field Data
EIN 84-2176596
Case Number EO-2021277-000209
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PERRY JOHNSON CHARITABLE FOUNDATION
Organization’s Mailing Address 755 W BIG BEAVER RD STE 1300
City TROY
State MI
ZIP 48084
Accounting period End 12
Primary contact name NORMAN BAKSA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PERRY JOHNSON
DIRECTOR
755 W BIG BEAVER RD STE 1300
TROY MI 48084

Officer/Director/Trustee Two

TERESA ODONNELL
TRUSTEE
755 W BIG BEAVER RD STE 1300
TROY MI 48084

Officer/Director/Trustee Three

NADYA ZOLOTAYA
TRUSTEE
755 W BIG BEAVER RD STE 1300
TROY MI 48084

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents No
Organization Incorporation Date 6/20/2019
Organization Incorporation State MI
Contains Limitation No
Does not expressly empower No
Contains dissolution No
National Taxonomy of Exempt Entities (NTEE) code T30 - Public 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 Yes
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 No
Signature Name NADYA ZOLOTAYA
Signature Title TRUSTEE
Signature Date 9/30/2021

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