FORM 1023-EZ for CHASE BJORK FOUNDATION

Field Data
EIN 84-4545620
Case Number EO-2020062-000023
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHASE BJORK FOUNDATION
Organization’s Mailing Address 338 COLLEGE ROAD
City CONCORD
State MA
ZIP 01742
Accounting period End 12
Primary contact name DAVID BJORK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID BJORK
DIRECTOR
338 COLLEGE ROAD
CONCORD MA 01742

Officer/Director/Trustee Two

BRYCE BJORK
DIRECTOR
338 COLLEGE RD
CONCORD MA 01742

Officer/Director/Trustee Three

CHRISTAL BJORK
DIRECTOR
338 COLLEGE ROAD
CONCORD MA 01742

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/3/2020
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F80 - Mental Health Association, Multipurpose
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 DAVID BJORK
Signature Title DIRECTOR
Signature Date 2/26/2020

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