FORM 1023-EZ for THE SOUTHWEST INSITUTE

Field Data
EIN 83-4722158
Case Number EO-2019133-000635
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE SOUTHWEST INSITUTE
Organization’s Mailing Address POB 3334
City KINGMAN
State AZ
ZIP 86402
Accounting period End 12
Primary contact name NORMAN UMBERGER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NORMAN UMBERGER
DIRECTOR
3219 N YAVAPAI ST
KINGMAN AZ 86401

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/17/18
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B02 - Management & Technical Assistance
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name NORMAN UMBERGER
Signature Title DIRECTOR
Signature Date 5/10/19

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