FORM 1023-EZ for AUTISTICFUSION

Field Data
EIN 81-3306148
Case Number EO-2016265-000160
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AUTISTICFUSION
Organization’s Mailing Address 4423 W 68TH DR
City WESTMINSTER
State CO
ZIP 80030
Accounting period End 12
Primary contact name MIKAYLA HOUSER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MIKAYLA HOUSER
MEMBER
7402 W CHURCH RANCH BLVD APT 6210
WESTMINSTER CO 80021

Officer/Director/Trustee Two

SARAH CONNELL
MEMBER
8331 S VALLEY HWY APT 301
ENGLEWOOD CO 80112

Officer/Director/Trustee Three

KENTON SCHASSBERGER
MEMBER
2941 W 81ST AVE UNIT K
WESTMINSTER CO 80031

Officer/Director/Trustee Four

ANGELA KIRKPATRICK
MEMBER
200 IDALIA CT APT 2201
AURORA CO 80011

Officer/Director/Trustee Five

JANE STRAUS
MEMBER
3026 36TH AVENUE SOUTH
MINNEAPOLIS MN 55406

Organization’s website
Organization’s email MIKAYLA@AUTISTICFUSION.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/6/2016
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G84 - Autism
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 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 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
Signature Title
Signature Date

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