FORM 1023-EZ for DESERVING DENTAL ORG

Field Data
EIN 84-2369341
Case Number EO-2019214-000336
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DESERVING DENTAL ORG
Organization’s Mailing Address 2205 W 136TH AVE SUITE 106-159
City BROOMFIELD
State CO
ZIP 80023
Accounting period End 12
Primary contact name JENNIFER GEISELHOFER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNIFER GEISELHOFER
DIRECTOR, CHAIR OF BOARD, PRESIDENT
2205 W 136TH AVE SUITE 106-159
BROOMFIELD CO 80023

Officer/Director/Trustee Two

GREG TERCH
DIRECTOR, TREASURER
2205 W 136TH AVE SUITE 106-159
BROOMFIELD CO 80023

Officer/Director/Trustee Three

MARY DUNN
DIRECTOR, SECRETARY
2205 W 136TH AVE SUITE 106-159
BROOMFIELD CO 80023

Officer/Director/Trustee Four

HARTEJ SOOD
DIRECTOR
2205 W 136TH AVE SUITE 106-159
BROOMFIELD CO 80023

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/11/19
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative N.E.C.
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 Yes
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 JENNIFER GEISELHOFER
Signature Title DIRECTOR, CHAIR OF BOARD, PRESIDENT
Signature Date 7/31/19

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