FORM 1023-EZ for INTEGRATIVE TRAUMA TREATMENT INTERNATIONAL INC

Field Data
EIN 32-0576517
Case Number EO-2018312-000123
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name INTEGRATIVE TRAUMA TREATMENT INTERNATIONAL INC
Organization’s Mailing Address 2130 SW JEFFERSON STREET SUITE 200
City PORTLAND
State OR
ZIP 97201
Accounting period End 12
Primary contact name ATHENA PHILLIPS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIFFANY RYAN
PRESIDENT
1022 SE 42ND AVENUE
PORTLAND OR 97215

Officer/Director/Trustee Two

ATHENA PHILLIPS
VICE PRESIDENT
3225 CIRCLE CREST
FOREST GROVE OR 97116

Officer/Director/Trustee Three

ELIZABETH DEFEHR
SECRETARY
12931 SE 155TH
HAPPY VALLEY OR 97086

Officer/Director/Trustee Four

ANNEMIEKE CLARK
TREASURER
6921 NE 15TH AVENUE
PORTLAND OR 97211

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/2/18
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F80 - Mental Health Association, 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 Yes
Donation of funds No
Conducting Activities Outside of United States Yes
Financial transactions with officers Yes
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 ATHENA PHILLIPS
Signature Title VICE PRESIDENT
Signature Date 11/5/18

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