FORM 1023-EZ for GOLDBERG FAMILY FOUNDATION

Field Data
EIN 85-0985485
Case Number EO-2020134-000226
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GOLDBERG FAMILY FOUNDATION
Organization’s Mailing Address 933 STATE STREET S
City KIRKLAND
State WA
ZIP 98033
Accounting period End 12
Primary contact name TODD GOLDBERG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TODD GOLDBERG
DIRECTOR
933 STATE STREET S
KIRKLAND WA 98033

Officer/Director/Trustee Two

MICHELLE GOLDBERG
DIRECTOR
933 STATE STREET S
KIRKLAND WA 98033

Officer/Director/Trustee Three

JACK GOLDBERG
DIRECTOR
13311 NE 173RD STREET APT A517
WOODINVILLE WA 98072

Officer/Director/Trustee Four

NEIL GOLDBERG
DIRECTOR
13211 ADAIR CREEK WAY NE
REDMOND WA 98053

Officer/Director/Trustee Five

BERNEL GOLDBERG
DIRECTOR
5232 221ST PLACE SE
MERCER ISLAND WA 98040

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/10/2014
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
Organization’s purpose Charitable: No
Religious: No
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TODD GOLDBERG
Signature Title DIRECTOR
Signature Date 5/11/2020

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