FORM 1023-EZ for A SURE FOUNDATION

Field Data
EIN 83-3907602
Case Number EO-2019073-000387
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name A SURE FOUNDATION
Organization’s Mailing Address 364 WEST 3900 NORTH
City PROVO
State UT
ZIP 84604-4983
Accounting period End 12
Primary contact name JOHN W BUCKLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN BUCKLEY
DIRECTOR
364 WEST 3900 NORTH
PROVO UT 84604-4983

Officer/Director/Trustee Two

DIANE BUCKLEY
DIRECTOR
364 WEST 3900 NORTH
PROVO UT 84604-4983

Officer/Director/Trustee Three

MICHAEL BUCKLEY
DIRECTOR
4199 WEST 1650 NORTH
LEHI UT 84043-6174

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/14/18
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T22 - Private Independent Foundations
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
Literary: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JOHN BUCKLEY
Signature Title DIRECTOR
Signature Date 3/12/19

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