FORM 1023-EZ for USAPA MOUNTAIN REGION - NON PROFIT

Field Data
EIN 82-2895206
Case Number EO-2018157-000126
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name USAPA MOUNTAIN REGION - NON PROFIT
Organization’s Mailing Address 1964 WOODMOOR DRIVE
City BOUNTIFUL
State UT
ZIP 84010
Accounting period End 12
Primary contact name MIKE NIELSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOLENE NIELSEN
DIRECTOR #1
1064 WOODMOOR DRIVE
BOUNTIFUL UT 84010

Officer/Director/Trustee Two

MIKE NIELSEN
DIRECTOR #2
1064 WOODMOOR DRIVE
BOUNTIFUL UT 84010

Officer/Director/Trustee Three

KEVIN OLSON
DIRECTOR #3
1182 EAST 1850 SOUTH
BOUNTIFUL UT 84010

Officer/Director/Trustee Four

LAREE OLSON
DIRECTOR #4
1182 EAST 1850 SOUTH
BOUNTIFUL UT 84010

Organization’s website
Organization’s email MNIELSEN@USAPA.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/30/17
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
Organization’s purpose Charitable: No
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 Yes
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MIKE NIELSEN
Signature Title DIRECTOR #2
Signature Date 6/4/18

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