FORM 1023-EZ for JEFFERSON COUNTY PRIDE

Field Data
EIN 82-5053228
Case Number EO-2018116-000156
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JEFFERSON COUNTY PRIDE
Organization’s Mailing Address 33 NORTH PALMER DRIVE
City PORT TOWNSEND
State VA
ZIP 98368-9222
Accounting period End 12
Primary contact name RAY GRAVES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBYN LYNN
PRESIDENT
5308 LANDES STREET
PORT TOWNSEND WA 98368-9222

Officer/Director/Trustee Two

HENRIEMELIA DE SOUZA
VICE PRESIDENT
164 SWANSON AVE
PORT TOWNSEND WA 98368-9222

Officer/Director/Trustee Three

RAY GRAVES
SECRETARY
33 NORTH PALMER DRIVE
PORT TOWNSEND WA 98368-9222

Officer/Director/Trustee Four

PENELOPE JENSEN
TREASURER
121 VICTORIA LOOP
PORT TOWNSEND WA 98368-9222

Officer/Director/Trustee Five

TONY BROWN BROWN
MEMBER
921 MCPHERSON STREET
PORT TOWNSEND WA 98368-9222

Organization’s website JEFFERSONCOUNTYPRIDE.ORG
Organization’s email JEFFERSONCOUNTYPRIDE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/30/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code R01 - Alliance/Advocacy Organizations
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 HENRIEMELIA DE SOUZA
Signature Title VICE PRESIDENT
Signature Date 4/24/18

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