FORM 1023-EZ for PASS THE HELMET

Field Data
EIN 46-4215276
Case Number EO-2015082-000253
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PASS THE HELMET
Organization’s Mailing Address 9250 SE WILLOCK RD
City OLALLA
State WA
ZIP 98359
Accounting period End 6
Primary contact name MARTIN ROWE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARTIN ROWE
CHAIR
9250 SE WILLOCK RD
OLALLA WA 98359

Officer/Director/Trustee Two

MICHELLE HODGES
SECRETARY/TREASURER
1250 NW TIMBER SHADOW CT
SILVERDALE WA 98383

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/12/2013
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P12 - 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 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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