FORM 1023-EZ for INJURY PREVENTION PROJECT INC

Field Data
EIN 84-1814928
Case Number EO-2019288-000549
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name INJURY PREVENTION PROJECT INC
Organization’s Mailing Address 11505 PACIFIC ST
City OMAHA
State NE
ZIP 68154
Accounting period End 12
Primary contact name DAVID POTACH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID POTACH
FOUNDER AND CEO
11505 PACIFIC ST
OMAHA NE 68154

Organization’s website PREVENTINJURIES.ORG
Organization’s email DAVID@PREVENTINJURIES.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/16/19
Organization Incorporation State DE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: No
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 Yes
Donation of funds No
Conducting Activities Outside of United States Yes
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 DAVID POTACH
Signature Title FOUNDER AND CEO
Signature Date 10/13/19

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