FORM 1023-EZ for GRASSROOTS CHILDRENS FOUNDATION

Field Data
EIN 81-2354117
Case Number EO-2016123-000279
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GRASSROOTS CHILDRENS FOUNDATION
Organization’s Mailing Address 1904 W 960 N
City PROVO
State UT
ZIP 84604
Accounting period End 12
Primary contact name SHARA SUMNALL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BECKY JOHNSON
PRESIDENT
1904 W 960 N
PROVO UT 84604

Officer/Director/Trustee Two

SHARA SUMNALL
VICE PRESIDENT
471 EAST 900 SOUTH
OREM UT 84097

Officer/Director/Trustee Three

JODIE THORNTON
SECRETARY
927 N INDEPENDENCE AVE
PROVO UT 84604

Officer/Director/Trustee Four

CAMI HENRIE
TREASURER
1190 WEST 820 NORTH
PROVO UT 84604

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/25/2016
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Q33 - International Relief
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 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
Signature Title
Signature Date

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