FORM 1023-EZ for INTSIKA FOUNDATION

Field Data
EIN 83-3606031
Case Number EO-2019247-000192
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name INTSIKA FOUNDATION
Organization’s Mailing Address 657 E HOLLYWOOD AVE
City SALT LAKE CITY
State UT
ZIP 84105
Accounting period End 12
Primary contact name LESLIE HADFIELD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LESLIE HADFIELD
DIRECTOR
657 E HOLLYWOOD AVE
SALT LAKE CITY UT 84105

Officer/Director/Trustee Two

JULIE ORME
DIRECTOR
9409 SPRING HOUSE LANE APT A
LAUREL MD 20108

Officer/Director/Trustee Three

AIMEE LATTA
DIRECTOR
150 BENNETT AVE APT 4A
NYC NY 10040

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/19/18
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 LESLIE HADFIELD
Signature Title DIRECTOR
Signature Date 9/2/19

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