FORM 1023-EZ for ELSIE DENT KHAN FOUNDATION

Field Data
EIN 83-4325306
Case Number EO-2019140-000519
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ELSIE DENT KHAN FOUNDATION
Organization’s Mailing Address PO BOX 14512
City RALEIGH
State NC
ZIP 27620
Accounting period End 12
Primary contact name SHAANEEN COLLINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHAANEEN COLLINS
PRESIDENT
1108 RAVEN PERCH DR
WENDELL NC 27591

Officer/Director/Trustee Two

NAZIM KHAN
VICE-PRESIDENT
302 JAY TRAIL
MURFREESBORO NC 27855

Officer/Director/Trustee Three

DANIELLE KHAN-BLACKWELL
TREASURER
5832 CARRETTA COURT
RALEIGH NC 27610

Officer/Director/Trustee Four

NAZEIDRE KHAN-GOLDSMITH
SECRETARY
605 HOPE VALLEY RD
KNIGHTDALE NC 27545

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/2/19
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
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 SHAANEEN COLLINS
Signature Title PRESIDENT
Signature Date 5/18/19

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