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Has the organization filed its first 990?

YES NO

Do you have a State Charitable Solicitations Permit or Letter of

Exemption? YES NO

If you answered NO to any of these questions, please contact

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Organization Name Tierra Lucero

Address P.O. Box 932, Taos, NM 87571

____________

Phone 575-779-5457 Fax 575-776- 3637

Website www.tierralucero.org

Executive Director’s Name Bob Pedersen

Executive Director’s Email growfoodnow@gmail.com

Year of Incorporation 2001 Tax ID Number (FIN) tax ID goes

here

Mission Statement (2000 Character Limit)

Our mission is to create energy sovereignty for our community through the local production of
food and fuel. We seek to develop and demonstrate models that can be used by communities in
the U.S. and around the world.
Who should we contact to complete the profile? Bob
Pedersen_________________________

Email address:
growfoodnow@gmail.com_______________

Attach copy of:

• 501 (c) (3) IRS determination letter
• State Charitable Solicitations Permit or letter of exemption
www.newmexico.gov/sos/charity

Return to: Santa Fe Community Foundation

P.O. Box 1827
Santa Fe, NM 87504-1827
Fax: 505.988.1829

Date of application: November 20, 2010

Name of organization. Tierra Lucero 501c3
Purpose of grant: To educate Taos school children about nutrition and local agriculture in order
that they may make better food choices, nutritionally and environmentally.

Address of organization: P.O. Box 932, Taos, NM 87571

Telephone number: 575-779-5457

Executive director: Bob Pedersen

Contact person and title: Jennifer Rice, Director of Fundraising

Is your organization an IRS 501(c)(3) not-for-profit? (yes or no): Yes

If no, please explain:

Grant request: $25,000

Check one: General support: ___ Project support: X

Total organizational budget (for current fiscal year): $200,000

Budget Period (mo/day/year): January 1, 2010 - through December 31, 2010

Total project budget (if requesting project support): $47,484

Dates covered by project budget (mo/day/year): June 1, 2010 - December 31, 2010

Project name: Food is Elementary in Taos

Insert 501 (c) (3) IRS determination letter here
Insert State Charitable Solicitations Permit or letter of
exemption here