FORM 1023-EZ for TSALAGI INDIGENOUS NATIVE AMERICANASSOCIATION OF TRIBAL NATIONS

Field	Data
EIN	83-2883150
Case Number	EO-2019169-000351
Form 1023-EZ version	12018
Eligibility Worksheet	1
Organization Name	TSALAGI INDIGENOUS NATIVE AMERICANASSOCIATION OF TRIBAL NATIONS
Organization’s Mailing Address	ONE MENDON RD SUITE 310
City	CUMBERLAND
State	RI
ZIP	2864
Accounting period End	12
Primary contact name	KARL VON CLEGG
Primary contact phone	[Hidden]
Primary contact phone extension	[Hidden]
Primary contact fax	[Hidden]
User fee submitted	$275.00

Officer/Director/Trustee One

KARL VON CLEGG
EXECUTIVE DIRECTOR
ONE MENDON ROAD SUITE 310
CUMBERLAND RI 2864

Officer/Director/Trustee Two

NATHANIEL FOUNTAIN
PRESIDENT
146 VIRGINIA STREET
BUFFALO NY 14201

Officer/Director/Trustee Three

REBECCA VON CLEGG
VICE PRESIDENT
10 KEANE STREET
LINCOLN RI 2865

Officer/Director/Trustee Four

GWENDOLYN FOUNTAIN
SECRETARY-TREASURER
146 VIRGINIA STREET
BUFFALO NY 14201

Organization’s website
Organization’s email
Organization Incorporated	Yes
Organization trust	No
Necessary Organizing Documents	Yes
Organization Incorporation Date	3/12/19
Organization Incorporation State	RI
Contains Limitation	Yes
Does not expressly empower	Yes
Contains dissolution	Yes
National Taxonomy of Exempt Entities (NTEE) code	J20 - Employment Procurement Assistance, Job Training
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	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	Yes
Benefit of College	No
Private Foundation 508(e)	No
Seeking Retroactive Reinstatement	No
Seeking Section 7 Reinstatement	No
Correctness Declaration	Yes
Signature Name	KARL VON CLEGG
Signature Title	EXECUTIVE DIRECTOR
Signature Date	6/13/19
EIN	83-2883150
Case Number	EO-2019169-000351
Form 1023-EZ version	12018
Eligibility Worksheet	1
Organization Name	TSALAGI INDIGENOUS NATIVE AMERICAN ASSOCIATION OF TRIBAL NATIONS
Organization’s Mailing Address	ONE MENDON RD SUITE 310
City	CUMBERLAND
State	RI
ZIP	2864
Accounting period End	12
Primary contact name	KARL VON CLEGG
Primary contact phone	[Hidden]
Primary contact phone extension	[Hidden]
Primary contact fax	[Hidden]
User fee submitted	$275.00