FORM 1023-EZ for THE PAYTON ELISE BENSON FOUNDATION INC

Field Data
EIN 81-3741161
Case Number EO-2016312-000488
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE PAYTON ELISE BENSON FOUNDATION INC
Organization’s Mailing Address 402 N 38 AVE
City OMAHA
State NE
ZIP 68131
Accounting period End 12
Primary contact name TABATHA MANNING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TABATHA MANNING
DIRECTOR / PRESIDENT
4464 REDMAN AVE APT 6
OMAHA NE 68111

Officer/Director/Trustee Two

SHARMEEN BENSON
DIRECTOR
402 N 38 AVE
OMAHA NE 68131

Officer/Director/Trustee Three

LEAH VONSEGGERN
DIREC
1211 SOUTH 121 PLAZA UNIT 318
OMAHA NE 68144

Officer/Director/Trustee Four

DANIELLE FRIGGE
DIRECTOR
2601 NOTTINGHAM COURT APT 1
COUNCIL BLUFFS IA 51503

Officer/Director/Trustee Five

AMY FLEMING
DIRECTOR
6416 N 106 ST
OMAHA NE 68134

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/6/2016
Organization Incorporation State NE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O5O -
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 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 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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