FORM 1023-EZ for PORTLAND FREE PLAY

Field Data
EIN 30-1011364
Case Number EO-2019036-000110
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PORTLAND FREE PLAY
Organization’s Mailing Address 707 NE BROADWAY - SUITE 203
City PORTLAND
State OR
ZIP 97232-1271
Accounting period End 12
Primary contact name LEON SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LEON SMITH
PRESIDENT
707 NE BROADWAY - SUITE 203
PORTLAND OR 97232-1271

Officer/Director/Trustee Two

KATIE SHOOK
SECRETARY
1151 NE MEADOW DRIVE
PORTLAND OR 97211

Officer/Director/Trustee Three

PEGGY WATTERS
TREASURER
1447 HOLLY STREET
WEST LINN OR 97068

Officer/Director/Trustee Four

STEVE DAVEE
BOARD MEMBER
2134 N ALBERTA ST
PORTLAND OR 97217-3507

Officer/Director/Trustee Five

BRIAN OUTLAW
BOARD MEMBER
4344 NE HASSALO ST
PORTLAND OR 97213

Organization’s website PORTLANDFREEPLAY.COM
Organization’s email PORTLANDFREEPLAY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/16/17
Organization Incorporation State OR
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: 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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name LEON SMITH
Signature Title PRESIDENT
Signature Date 1/16/19

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