FORM 1023-EZ for PEAK LIVING COMMUNITY FOUNDATION

Field Data
EIN 81-2776847
Case Number EO-2017195-000208
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PEAK LIVING COMMUNITY FOUNDATION
Organization’s Mailing Address 304 MICHIGAN AVENUE
City MANITOU SPRINGS
State CO
ZIP 80829
Accounting period End 12
Primary contact name KEN JARAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEN JARAY
DIRECTOR
304 MICHIGAN AVENUE
MANITOU SPRINGS CO 80829

Officer/Director/Trustee Two

ANN NICHOLS
DIRECTOR
208 PAWNEE AVENUE
MANITOU SPRINGS CO 80829

Officer/Director/Trustee Three

JIM PAGE
DIRECTOR
17 VIA LOMA
MANITOU SPRINGS CO 80829

Organization’s website WWW.PEAKLIVINGMANITOUSPRINGS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/27/2016
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N01 - Alliance/Advocacy Organizations
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 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
Signature Title
Signature Date

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