FORM 1023-EZ for EVERGREEN PTA

Field Data
EIN 91-1770732
Case Number EO-2014266-000137
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EVERGREEN PTA
Organization’s Mailing Address 9010 BLAINE AVE
City FORT LEWIS
State WA
ZIP 98433
Accounting period End 7
Primary contact name ANDREA ALLEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ALEXADRIA GALLEGOS
PRESIDENT
6819 HAWTHORNE LANE
JBLM WA 98433

Officer/Director/Trustee Two

AMBER HENRIQUEZ
VICE PRESIDENT
6952 HOLLY DR
JBLM WA 98433

Officer/Director/Trustee Three

ANDREA ALLEN
TREASURER
6790 ROSEMARY LANE
JBLM WA 98433

Organization’s website
Organization’s email EGPTA@CLOVERPARK.K12.WA.US
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/1/1997
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B94 - Parent/Teacher Group
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 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
Signature Title
Signature Date

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