FORM 1023-EZ for KELLY NICOLE FOUNDATION
| Field | Data |
|---|---|
| EIN | 81-1592110 |
| Case Number | EO-2016294-000226 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | KELLY NICOLE FOUNDATION |
| Organization’s Mailing Address | 4707 W 40TH ST |
| City | ST. LOUIS PARK |
| State | MN |
| ZIP | 55416 |
| Accounting period End | 12 |
| Primary contact name | ALEX BAJWA |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
THERESA HOLL
PRESIDENT
4707 W 40TH ST
ST. LOUIS PARK MN 55416
Officer/Director/Trustee Two
HOLLY LATCHAM
VICE PRESIDENT
7608 12TH AVE S
RICHFIELD MN 55423
Officer/Director/Trustee Three
JUSTIN SCHWARTZBAUER
TREASURER
7608 12TH AVE S
RICHFIELD MN 55423
Officer/Director/Trustee Four
JAMES HARLEY
SECRETARY
12700 NICOLLET AVE UNIT 334
BURNSVILLE MN 55423
Officer/Director/Trustee Five
LORI DOKKEN
BOARD MEMBER
2309 HARRIET AVE
MINNEAPOLIS MN 55405
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 2/25/2016 |
| Organization Incorporation State | MN |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | A30 - Media, Communications Organizations |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes Scientific: No 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 | |
| Signature Title | |
| Signature Date |
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