FORM 1023-EZ for EMPOWER INDIGENOUS MEXICO FOUNDATION

Field Data
EIN 84-2203677
Case Number EO-2019184-000240
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EMPOWER INDIGENOUS MEXICO FOUNDATION
Organization’s Mailing Address 1
City FARMINGTON
State UT
ZIP 84025
Accounting period End 12
Primary contact name DAVID GILLIES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID GILLIES
DIRECTOR
1222 OAKRIDGE PARK DRIVE
FARMINGTON UT 84025

Officer/Director/Trustee Two

CHERYL GILLIES
DIRECTOR
1222 OAKRIDGE PARK DR
FARMINGTON UT 84025

Officer/Director/Trustee Three

CORY BROWN
DIRECTOR
1627 OAKRIDGE PARK DR
FARMINGTON UT 84025

Officer/Director/Trustee Four

HEIDI BROWN
DIRECTOR
1624 OAKRIDGE PARK DR
FARMINGTON UT 84025

Organization’s website NA
Organization’s email DGILLIES@CONSULMED.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/25/19
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B99 - Education 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 No
Donation of funds Yes
Conducting Activities Outside of United States Yes
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 DAVID GILLIES
Signature Title DIRECTOR
Signature Date 7/1/19

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