FORM 1023-EZ for TALIAS VOICE - PROJECTS FOR PATIENTSAFETY

Field Data
EIN 82-1803213
Case Number EO-2017173-000262
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TALIAS VOICE - PROJECTS FOR PATIENTSAFETY
Organization’s Mailing Address 3238 EDENDALE LANE
City EUGENE
State OR
ZIP 97405
Accounting period End 12
Primary contact name DAVID E ATKIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEFF GOLDENBERG
PRESIDENT
3238 EDENDALE LANE
EUGENE OR 97405

Officer/Director/Trustee Two

JEFF KIRTNER
DIRECTOR
3272 BRYCELER DR
EUGENE OR 97405

Officer/Director/Trustee Three

ELIZABETH REIS
SECRETARY
422 E 72ND STREET APARTMENT 38A
NEW YORK NY 10021

Officer/Director/Trustee Four

RITA RADOSTITZ
TREASURER
1347 QUINCY STREET
WASHINGTON DC 20011

Officer/Director/Trustee Five

DEBORAH FUERTH
DIRECTOR
4344 N SHASTA LOOP
EUGENE OR 97405

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/16/2017
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence Yes
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 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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