FORM 1023-EZ for ATLAS AUTISM

Field Data
EIN 82-4770435
Case Number EO-2018101-000306
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ATLAS AUTISM
Organization’s Mailing Address 52 VALE CIR
City PALMER LAKE
State CO
ZIP 80133
Accounting period End 12
Primary contact name KYLE ARCHIBEQUE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KYLE ARCHIBEQUE
PRESIDENT
52 VALE CIR
PALMER LAKE CO 80133

Officer/Director/Trustee Two

KATELYN LAVIANO
SECRETARY, TREASURER
52 VALE CIR
PALMER LAKE CO 80133

Officer/Director/Trustee Three

AMANDA ARCHIBEQUE
BOARD MEMBER
52 VALE CIR
PALMER LAKE CO 80133

Officer/Director/Trustee Four

GLENN TIPPY
BOARD MEMBER
52 VALE CIR
PALMER LAKE CO 80133

Organization’s website
Organization’s email ARCHIBEQUE.KYLE.J@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/7/18
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T30 - Public Foundations
Organization’s purpose Charitable: Yes
Religious: No
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 Yes
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 KYLE ARCHIBEQUE
Signature Title PRESIDENT
Signature Date 4/9/18

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