FORM 1023-EZ for GUS BELT FAMILY FOUNDATION INC

Field Data
EIN 84-2969280
Case Number EO-2019266-000457
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GUS BELT FAMILY FOUNDATION INC
Organization’s Mailing Address 504 MEARS ROAD
City COTOPAXI
State CO
ZIP 81223
Accounting period End 12
Primary contact name THOMAS LANG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THOMAS LANG
PRESIDENT & TREASURER
504 MEARS ROAD
COTOPAXI CO 81223

Officer/Director/Trustee Two

JULIE LANG
SECRETARY
504 MEARS ROAD
COTOPAXI CO 81223

Officer/Director/Trustee Three

TERESA KRAEMER
VICE PRESIDENT
504 MEARS ROAD
COTOPAXI CO 81223

Organization’s website
Organization’s email TOMHOTRDA@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/5/19
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code R23 - Disabled Persons' Rights
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: Yes
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 THOMAS LANG
Signature Title PRESIDENT & TREASURER
Signature Date 9/20/19

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