FORM 1023-EZ for HELMETS FOR NANCY INC

Field Data
EIN 81-4688108
Case Number EO-2017067-000468
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HELMETS FOR NANCY INC
Organization’s Mailing Address 4514 COUNTY ROAD 5
City ERIE
State CO
ZIP 80516
Accounting period End 12
Primary contact name PHILLIP H GOODWIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PHILLIP GOODWIN
PRESIDENT
4514 COUNTY ROAD 5
ERIE CO 80516

Officer/Director/Trustee Two

JULIA GOODWIN
VICE PRESIDENT
4514 COUNTY ROAD 5
ERIE CO 80516

Officer/Director/Trustee Three

PAMELA JENKINS
TREASURER
5480 SUNSTONE LANE
CASTLE ROCK CO 80108

Officer/Director/Trustee Four

JOHN EALY
SECRETARY
6723 BIG HORN TRAIL
LITTLETON CO 80125

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/14/2016
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M40 - Safety Education
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
Signature Title
Signature Date

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