FORM 1023-EZ for GRASSROOTS FAITHFUL

Field Data
EIN 86-1298349
Case Number EO-2021096-000951
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GRASSROOTS FAITHFUL
Organization’s Mailing Address 62290 STARR LN
City LA GRANDE
State OR
ZIP 97850
Accounting period End 12
Primary contact name CORY LARVIK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NANCY ALLEN
DIRECTOR AND PRESIDENT
62290 STARR LN
LA GRANDE OR 97850

Officer/Director/Trustee Two

MATTHEW ALLEN
DIRECTOR
62290 STARR LN
LA GRANDE OR 97850

Officer/Director/Trustee Three

LEE ANN CONRO
DIRECTOR AND TREASURER
PO BOX 104
JORDAN VALLEY OR 97910

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/13/2020
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X83 - Religious Printing, Publishing
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 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 NANCY ALLEN
Signature Title DIRECTOR AND PRESIDENT
Signature Date 3/11/2021
EIN 86-1298349
Case Number EO-2021096-000951
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GRASSROOTS FAITHFUL
Organization’s Mailing Address 62290 STARR LN
City LA GRANDE
State OR
ZIP 97850
Accounting period End 12
Primary contact name CORY LARVIK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NANCY ALLEN
DIRECTOR AND PRESIDENT
62290 STARR LN
LA GRANDE OR 97850

Officer/Director/Trustee Two

MATTHEW ALLEN
DIRECTOR
62290 STARR LN
LA GRANDE OR 97850

Officer/Director/Trustee Three

LEE ANN CONRO
DIRECTOR AND TREASURER
PO BOX 104
JORDAN VALLEY OR 97910

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/13/2020
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X83 - Religious Printing, Publishing
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 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 NANCY ALLEN
Signature Title DIRECTOR AND PRESIDENT
Signature Date 3/11/2021

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