FORM 1023-EZ for THE BLANK EXCHANGE

Field Data
EIN 84-3490624
Case Number EO-2019337-000218
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE BLANK EXCHANGE
Organization’s Mailing Address 1314 N SKIDMORE STREET UNIT 233
City PORTLAND
State OR
ZIP 97217
Accounting period End 12
Primary contact name DEBORAH WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEBORAH WILLIAMS
PRESIDENT
1314 N SKIDMORE STREET UNIT 233
PORTLAND OR 97217

Officer/Director/Trustee Two

RALPH HODGE
DIRECTOR
1314 N SKIDMORE ST UNIT 233
PORTLAND OR 97217

Officer/Director/Trustee Three

ALECIA SMITH JONES
DIRECTOR
1314 N SKIDMORE STREET UNIT 233
PORTLAND OR 97217

Officer/Director/Trustee Four

SYDNEY THOMAS
DIRECTOR
1314 N SKIDMORE ST UNIT 233
PORTLAND OR 97217

Officer/Director/Trustee Five

ASHLEY DAVENPORT
DIRECTOR
1314 N SKIDMORE STREET UNIT 233
PORTLAND OR 97217

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/25/19
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: Yes
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 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 DEBORAH WILLIAMS
Signature Title PRESIDENT
Signature Date 12/1/19

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