FORM 1023-EZ for THE AGATE FOUNDATION

Field Data
EIN 83-2870134
Case Number EO-2019029-000807
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE AGATE FOUNDATION
Organization’s Mailing Address 8101 B EMERALD DRIVE
City EMERALD ISLE
State NC
ZIP 28594
Accounting period End 6
Primary contact name TAMARA LIASCHENKO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TAMARA LIASCHENKO
MEMBER
8101 B EMERALD DRIVE
EMERALD ISLE NC 28594

Officer/Director/Trustee Two

GRETA ENRIQUEZ
MEMBER
8101 B EMERALD DRIVE
EMERALD ISLE NC 28594

Organization’s website
Organization’s email THEAGATEFOUNDATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/12/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F12 - Fund Raising and/or Fund Distribution
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 Yes
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 Yes
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 TAMARA LIASCHENKO
Signature Title MEMBER
Signature Date 12/18/18

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