FORM 1023-EZ for PATTI NELSON FOUNDATION CORPORATION

Field Data
EIN 47-5254804
Case Number EO-2016125-000163
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PATTI NELSON FOUNDATION CORPORATION
Organization’s Mailing Address 400 OLD ROUTE 68
City EVANS CITY
State PA
ZIP 16033
Accounting period End 12
Primary contact name JAMES A NELSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES NELSON
PRESIDENT
400 OLD ROUTE 68
EVANS CITY PA 16033

Officer/Director/Trustee Two

DANIEL NELSON
VICE PRESIDENT
400 OLD ROUTE 68
EVANS CITY PA 16033

Officer/Director/Trustee Three

CASSANDRA NELSON
TREASURER
400 OLD ROUTE 68
EVANS CITY PA 16033

Officer/Director/Trustee Four

MICHELINA STICKNEY
SECRETARY
106 SPRINGHOUSE DR
BUTLER PA 16001

Officer/Director/Trustee Five

TAMMY NULPH
BOARD MEMBER
366 MERCER RD
HARMONY PA 16037

Organization’s website WWW.PATTIJNELSONFOUNDATION.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/7/2015
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A11 - Single Organization Support
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 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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