FORM 1023-EZ for BASE 4 CHARITY

Field Data
EIN 85-3925964
Case Number EO-2021053-000181
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BASE 4 CHARITY
Organization’s Mailing Address 567 N STATE RD 198
City SALEM
State UT
ZIP 84653
Accounting period End 12
Primary contact name TJ PHELPS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TJ PHELPS
DIRECTOR
1224 S 1740 W
PAYSON UT 84651

Officer/Director/Trustee Two

CYNDI JONES
DIRECTOR
1033 E 200 S
PAYSON UT 84651

Officer/Director/Trustee Three

MICHELLE GORDON
DIRECTOR
4238 E BLACKSTONE DR
RIGBY ID 83442

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/12/2020
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative N.E.C.
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 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) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TJ PHELPS
Signature Title DIRECTOR
Signature Date 12/23/2020

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