FORM 1023-EZ for DEPARTMENT OF PUBLIC TRANSFORMATION

Field Data
EIN 83-0770235
Case Number EO-2018157-000213
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DEPARTMENT OF PUBLIC TRANSFORMATION
Organization’s Mailing Address 726 PRENTICE STREET
City GRANITE FALLS
State MN
ZIP 56241
Accounting period End 12
Primary contact name ASHLEY HANSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ASHLEY HANSON
BOARD MEMBER
726 PRENTICE STREET
GRANITE FALLS MN 56241

Officer/Director/Trustee Two

MARY ROTHLISBERGER
BOARD MEMBER
PO BOX 364
PALOUSE WA 99161

Officer/Director/Trustee Three

HANNAH HOLMAN
BOARD MEMBER
3933 ULYSSES ST NE
COLUMBIA HEIGHTS MN 55421

Officer/Director/Trustee Four

ELLIE MOORE
BOARD MEMBER
875 MENLO OAKS DRIVE
MENLO PARK CA 94025

Officer/Director/Trustee Five

RANDI CARLSON
BOARD MEMBER
400 N EL MOLINO AVE
PASADENA CA 91101

Organization’s website WWW.PUBLICTRANSFORMATION.ORG
Organization’s email PUBLICTRANSFORMATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/4/18
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 ASHLEY HANSON
Signature Title BOARD MEMBER
Signature Date 6/4/18

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