FORM 1023-EZ for BRAVELY BIONIC FOUNDATION
| Field | Data |
|---|---|
| EIN | 47-5072423 |
| Case Number | EO-2016116-000402 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | BRAVELY BIONIC FOUNDATION |
| Organization’s Mailing Address | 542 BRIARWOOD DRIVE |
| City | MEDFORD |
| State | OR |
| ZIP | 97502 |
| Accounting period End | 12 |
| Primary contact name | CATLYN PETERSON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
Officer/Director/Trustee One
JOHN SPARACIO
PRESIDENT
788 110TH AVE NE N 2702
BELLEVUE WA 98004
Officer/Director/Trustee Two
CHARLES N VERSTEEG MD
VICE PRESIDENT
255 YALE DR
MEDFORD OR 97504
Officer/Director/Trustee Three
TYRAL C PETERSON
TREASURER
302 SW 27TH ST
REDMOND OR 97756
Officer/Director/Trustee Four
JUSTIN WILLIAMS
SECRETARY
2887 STRASBURG ST
MEDFORD OR 97504
Officer/Director/Trustee Five
CATLYN PETERSON
DIRECTOR
542 BRIARWOOD
MEDFORD OR 97502
| Organization’s website | WWW.BRAVELYBIONIC.COM/ |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/30/2015 |
| Organization Incorporation State | OR |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | H12 - Fund Raising and/or Fund Distribution |
| 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 | 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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