FORM 1023-EZ for EARTH PHARMA

Field Data
EIN 86-1972056
Case Number EO-2021089-000419
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EARTH PHARMA
Organization’s Mailing Address 6604 BAY CITY BND
City AUSTIN
State TX
ZIP 78725
Accounting period End 12
Primary contact name KELLI FOULKROD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLI FOULKROD
PRESIDENT, DIRECTOR
6604 BAY CITY BND
AUSTIN TX 78725

Officer/Director/Trustee Two

ROBIN SCOTT
TREASURER, DIRECTOR
8105 RED CV
AUSTIN TX 78748

Officer/Director/Trustee Three

NICOLE KEIR
SECRETARY, DIRECTOR
5412 DAIMLER
AUSTIN TX 78744

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/8/2021
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: Yes
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 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 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 KELLI FOULKROD
Signature Title PRESIDENT, DIRECTOR
Signature Date 2/12/2021

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