FORM 1023-EZ for BUCKETLIST FAMILY FOUNDATION

Field Data
EIN 82-3047237
Case Number EO-2018309-000560
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BUCKETLIST FAMILY FOUNDATION
Organization’s Mailing Address 2189 VISTA LA NISA
City CARLSBAD
State CA
ZIP 92009-9344
Accounting period End 12
Primary contact name MELANIE KABO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MELANIE KABO
CEO
2189 VISTA LA NISA
CARLSBAD CA 92009-9344

Organization’s website BUCKETLISTFAMILY.BLOGSPOT.COM
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/7/16
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G30 - Cancer
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MELANIE KABO
Signature Title CEO
Signature Date 11/3/18

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