FORM 1023-EZ for MOUNTAIN FOUNDATION

Field Data
EIN 37-1914333
Case Number EO-2018337-000402
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOUNTAIN FOUNDATION
Organization’s Mailing Address 133 SOUTH VAN GORDON ST SUITE 300
City LAKEWOOD
State CO
ZIP 80228
Accounting period End 6
Primary contact name LAURA LEWIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLY PAWLAK
PRESIDENT
133 SOUTH VAN GORDON ST SUITE 300
LAKEWOOD CO 80228

Officer/Director/Trustee Two

WIN SMITH
DIRECTOR
1840 SUGARBUSH ACCESS RD
WARREN VT 5674

Officer/Director/Trustee Three

ALAN HENCEROTH
DIRECTOR
PO BOX 5808
DILLON CO 80435

Officer/Director/Trustee Four

PAT CAMPBELL
DIRECTOR
390 INTERLOCKEN CRESCENT STE 1000
BROOMFIELD CO 80021

Officer/Director/Trustee Five

KEVIN MCCARTHY
DIRECTOR
48935 US HWY 12
WHITE PASS WA 98937

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/5/18
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N68 - Winter Sports (Snow and Ice)
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 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 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 KELLY PAWLAK
Signature Title PRESIDENT
Signature Date 11/30/18

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