FORM 1023-EZ for THE JANSENS FOUNDATION

Field Data
EIN 81-5444211
Case Number EO-2017060-000423
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE JANSENS FOUNDATION
Organization’s Mailing Address 20105 HOPPER STREET
City ELKHORN
State NE
ZIP 68022
Accounting period End 12
Primary contact name NEENA NIZAR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NEENA NIZAR
PRESIDENT
20105 HOPPER STREET
ELKHORN NE 68022

Officer/Director/Trustee Two

PENNI ROMERO
TREASURER
3460 PINEY CREEK DRIVE
ELKHORN NE 68022

Officer/Director/Trustee Three

MAEGEN WALLACE
SECRETARY
8200 DODGE STREET
OMAHA NE 68114

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/21/2017
Organization Incorporation State NE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G80 - Specifically Named Diseases
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 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
Signature Title
Signature Date

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