FORM 1023-EZ for PLANT BASED CO

Field Data
EIN 82-5137179
Case Number EO-2018236-000234
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PLANT BASED CO
Organization’s Mailing Address 600 WATER STREET SW UNIT 1-6
City WASHINGTON
State DC
ZIP 20024
Accounting period End 12
Primary contact name NATHANIEL PIERCE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GREGG ROZEBOOM
PRESIDENT, DIRECTOR
1624 LASKIN ROAD STE 740
VIRGINIA BEACH VA 23451

Officer/Director/Trustee Two

KATIE ROZEBOOM
TREASURER
209A 72ND STREET
VIRGINIA BEACH VA 23451

Officer/Director/Trustee Three

ANGELA ROZEBOOM
DIRECTOR
1185 MCCLELLAND STREET
GRANDVILLE MI 49418

Officer/Director/Trustee Four

EMILY BENSON
DIRECTOR
2220 WILLOW OAK CIRCLE APT 304
VIRGINIA BEACH VA 23451

Officer/Director/Trustee Five

RYAN BECKLUND
DIRECTOR
2407 1/2 20TH STREET NW
WASHINGTON DC 20009

Organization’s website PLANTBASED.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/11/18
Organization Incorporation State DC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K99 - Food, Agriculture, and Nutrition N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: No
Amateur Sports: Yes
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 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 GREGG ROZEBOOM
Signature Title PRESIDENT, DIRECTOR
Signature Date 8/22/18

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