FORM 1023-EZ for MP MEMORIAL FOUNDATION

Field Data
EIN 47-2241924
Case Number EO-2015015-000060
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MP MEMORIAL FOUNDATION
Organization’s Mailing Address 5307 64TH AVENUE NE
City MARYSVILLE
State WA
ZIP 98270
Accounting period End 12
Primary contact name JOLENE LASLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DANNA GIBSON
PRESIDENT
6119 72ND DRIVE NE
MARYSVILLE WA 98270

Officer/Director/Trustee Two

CHRISTEN DICKERSON
VICE PRESIDENT
8809 78TH DRIVE NE
MARYSVILLE WA 98270

Officer/Director/Trustee Three

JOLENE LASLEY
VICE PRESIDENT OF OPERATIONS
5307 64TH AVENUE NE
MARYSVILLE WA 98270

Officer/Director/Trustee Four

CHELSEA BERGESEN
VICE PRESIDENT OF COMPLIANCE
2145 DEXTER AVENUE NORTH UNIT 304
SEATTLE WA 98109

Officer/Director/Trustee Five

JULIE WENDELL
VICE PRESIDENT OF ADMINISTRATION
4813 FOREST DRIVE
EVERETT WA 98203

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/26/2014
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
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 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
Signature Title
Signature Date

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