FORM 1023-EZ for SATURDAY SAMARITANS

Field Data
EIN 82-1125659
Case Number EO-2017142-000638
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SATURDAY SAMARITANS
Organization’s Mailing Address 12775 SW FAIRCREST ST
City PORTLAND
State OR
ZIP 97225
Accounting period End 12
Primary contact name MIKE GRIMSHAW
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL GRIMSHAW
DIRECTOR
12775 SW FAIRCREST ST
PORTLAND OR 97225

Officer/Director/Trustee Two

MICHAEL TABOR
DIRECTOR
5304 NE 48TH AVE
PORTLAND OR 97218

Officer/Director/Trustee Three

MARILYN JOHNSON
DIRECTOR
3035 NE 23RD AVE
PORTLAND OR 97212

Officer/Director/Trustee Four

LINDA ACEDO
DIRECTOR
219 NE SHAVERS ST APT 19
PORTLAND OR 97211

Officer/Director/Trustee Five

PHILLIP SAKASH
DIRECTOR
7301 6TH AVE APT 19
TACOMA WA 98406

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/4/2017
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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 Yes
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
Signature Title
Signature Date

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