FORM 1023-EZ for SAM I CAN FOUNDATION
| Field | Data |
|---|---|
| EIN | 83-4131983 |
| Case Number | EO-2019116-000197 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | SAM I CAN FOUNDATION |
| Organization’s Mailing Address | 4917 ALEXIS ROAD |
| City | SYLVANIA |
| State | OH |
| ZIP | 43560 |
| Accounting period End | 12 |
| Primary contact name | LARA M JOSEPH |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
LARA JOSEPH
PRESIDENT
4917 ALEXIS ROAD
SYLVANIA OH 43560
Officer/Director/Trustee Two
THERESE KOPIWODA
VICE PRESIDENT
520 TAYLOR STREET
PENDLETON IN 46064
Officer/Director/Trustee Three
KAREN PRATT
TREASURER
5963 WHITEACRE ROAD
TOLEDO OH 43615
Officer/Director/Trustee Four
DENA DRENNER
SECRETARY
3487 SECTION ROAD
LAMBERTVILLE MI 48144
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 3/22/19 |
| Organization Incorporation State | OH |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | D12 - Fund Raising and/or Fund Distribution |
| 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 | 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 | LARA JOSEPH |
| Signature Title | PRESIDENT |
| Signature Date | 4/24/19 |
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