FORM 1023-EZ for REFUGEE ACTION FOR FAMILY HEALTH

Field Data
EIN 83-2575039
Case Number EO-2019259-001009
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name REFUGEE ACTION FOR FAMILY HEALTH
Organization’s Mailing Address 1450 S WEST TEMPLE APT H108
City SALT LAKE CITY
State UT
ZIP 84115
Accounting period End 12
Primary contact name SUSAN AKOK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUSAN AKOK
PRESIDENT/CHIEF EXECUTIVE OFFICER
1450 S WEST TEMPLE H108
SALT LAKE CITY UT 84115

Officer/Director/Trustee Two

MANNY AYUEL
SECRETARY
1015 SOUTH 200 WEST
SALT LAKE CITY UT 84101

Officer/Director/Trustee Three

ALUEL MAKUEI
TREASURER
1450 S WEST TEMPLE APT H108
SALT LAKE CITY UT 84115

Organization’s website
Organization’s email SUZAKOK@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/1/2018
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S99 - Community Improvement, Capacity Building N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 SUSAN AKOK
Signature Title PRESIDENT/CHIEF EXECUTIVE OFFICER
Signature Date 9/13/2019

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