FORM 1023-EZ for TRANSFORM

Field Data
EIN 86-2129874
Case Number EO-2021131-000235
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TRANSFORM
Organization’s Mailing Address 7765 WADSWORTH BLVD - NO 741082
City ARVADA
State CO
ZIP 80006-3044
Accounting period End 12
Primary contact name ALISSA M TRUMBULL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALISSA TRUMBULL
FOUNDER
7765 WADSWORTH BLVD - NO 741082
ARVADA CO 80006-3044

Officer/Director/Trustee Two

NORA RAHIMIAN
ADVISORY COUNCIL MEMBER
7765 WADSWORTH BLVD - NO 741082
ARVADA CO 80006-3044

Officer/Director/Trustee Three

MOLLY FIDLOW
ADVISORY COUNCIL MEMBER
6554 N GLENWOOD AVE
CHICAGO IL 60626-6369

Officer/Director/Trustee Four

SARA POWELL
ADVISORY COUNCIL MEMBER
8225 FAIRMOUNT DR
DENVER CO 80247-1148

Officer/Director/Trustee Five

JENNY KOCH
ADVISORY COUNCIL MEMBER
7765 WADSWORTH BLVD - NO 741082
ARVADA CO 80006-3044

Organization’s website WWW.TRANSFORMGRANT.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/12/2020
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S40 - Business and Industry
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 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 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 ALISSA TRUMBULL
Signature Title FOUNDER
Signature Date 5/8/2021

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