FORM 1023-EZ for COUNT ON KIDS

Field Data
EIN 83-0668067
Case Number EO-2018150-000225
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COUNT ON KIDS
Organization’s Mailing Address 1272 TERRACINA DRIVE
City EL DORADO HILLS
State CA
ZIP 95762
Accounting period End 12
Primary contact name KELLI PLEVYAK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLI PLEVYAK
CHIEF EXECUTIVE OFFICER
1272 TERRACINA DRIVE
EL DORADO HILLS CA 95762

Officer/Director/Trustee Two

HEATHER SCHOTT
SECRETARY
8380 CORTINA CIRCLE
ROSEVILLE CA 95678

Officer/Director/Trustee Three

JESSICA HALLBOURG
TREASURER
3333 QUALITY DRIVE
RANCHO CORDOVA CA 95670

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/11/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O51 - Youth Community Service Clubs
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: Yes
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 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 KELLI PLEVYAK
Signature Title CHIEF EXECUTIVE OFFICER
Signature Date 5/24/18

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