FORM 1023-EZ for MORTENSON FOUNDATION INC

Field Data
EIN 86-2688528
Case Number EO-2021190-000260
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MORTENSON FOUNDATION INC
Organization’s Mailing Address 7822 SOUTH MCCANN RD
City SOUTHPORT
State FL
ZIP 32409
Accounting period End 12
Primary contact name EILEEN MORTENSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DALE MORTENSON
PRESIDENT
7822 SOUTH MCCANN RD
SOUTHPORT FL 32409

Officer/Director/Trustee Two

EILEEN MORTENSON
TREASURER
7822 SOUTH MCCANN RD
SOUTHPORT FL 32409

Officer/Director/Trustee Three

IMMANUEL MORTENSON
DIRECTOR
7870 SOUTH MCCANN RD
SOUTHPORT FL 32409

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/18/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DALE MORTENSON
Signature Title PRESIDENT
Signature Date 7/7/2021

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