FORM 1023-EZ for ROLE MODEL MENTORS FRONT RANGE

Field Data
EIN 84-3765560
Case Number EO-2020024-000406
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROLE MODEL MENTORS FRONT RANGE
Organization’s Mailing Address 635 CORONADO PLACE
City LONGMONT
State CO
ZIP 80504-2319
Accounting period End 12
Primary contact name DAVID SHATTUCK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RYAN BRENNEMAN
DIRECTOR, VICE CHAIRMAN
2138 REDFIELD CIRCLE
LONGMONT CO 80504-9210

Officer/Director/Trustee Two

JEFF GILES
DIRECTOR, CHAIRMAN
809 13TH STREET
BERTHOUD CO 80513-1127

Officer/Director/Trustee Three

JAMES SHATTUCK
DIRECTOR, TREASURER
3398 CUCHARA COURT
LOVELAND CO 80538-5576

Officer/Director/Trustee Four

DAVID SHATTUCK
EXECUTIVE DIRECTOR, SECRETARY
635 CORONADO PLACE
LONGMONT CO 80504-2319

Organization’s website WWW.RMMFRONTRANGE.ORG
Organization’s email RMMFRONTRANGE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/20/2019
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DAVID SHATTUCK
Signature Title EXECUTIVE DIRECTOR, SECRETARY
Signature Date 1/22/2020

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