FORM 1023-EZ for THE JACOB EMERSON FOUNDATION

Field Data
EIN 84-4525663
Case Number EO-2020038-000194
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE JACOB EMERSON FOUNDATION
Organization’s Mailing Address 1493 OPHIR RD
City CASTLEROCK
State CO
ZIP 80109
Accounting period End 12
Primary contact name ELIZABETH EMERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ELIZABETH EMERSON
PRESIDENT / DIRECTOR
1493 OPHIR RD
CASTLEROCK CO 80109

Officer/Director/Trustee Two

PAUL HEFNER
TREASURER / DIRECTOR
1493 OPHIR RD
CASTLEROCK CO 80109

Officer/Director/Trustee Three

LISA WEISS
SECRETARY / DIRECTOR
1493 OPHIR RD
CASTLEROCK CO 80109

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/30/2020
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F99 - Mental Health, Crisis Intervention N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 ELIZABETH EMERSON
Signature Title PRESIDENT / DIRECTOR
Signature Date 2/5/2020

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