FORM 1023-EZ for THE GROVE INITIATIVE

Field Data
EIN 84-3467743
Case Number EO-2019303-000460
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE GROVE INITIATIVE
Organization’s Mailing Address 630 HICKORY ST STE 120 PMB 104
City ALBANY
State OR
ZIP 97321
Accounting period End 12
Primary contact name TIM FIEF
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRANDI MENDINHALL
PRESIDENT
2251 NE EVERGREEN AVE
ALBANY OR 97321

Officer/Director/Trustee Two

TIM FIEF
SECRETARY
4060 NW CAMALA DRIVE
ALBANY OR 97321

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/22/19
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 Yes
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 TIM FIEF
Signature Title SECRETARY
Signature Date 10/28/19

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