FORM 1023-EZ for SAFETY NET

Field Data
EIN 36-4813663
Case Number EO-2016060-000355
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SAFETY NET
Organization’s Mailing Address 2400 NE BROADWAY ST
City PORTLAND
State OR
ZIP 97232
Accounting period End 6
Primary contact name KATHRYN BRIGHTBILL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DARREN MCDONALD
PRESIDENT
2400 NE BROADWAY ST
PORTLAND OR 97232

Officer/Director/Trustee Two

ELLIE ASH-BALA
TREASURER
645 S INDIAN HILL B
CLAREMONT CA 91711

Officer/Director/Trustee Three

RUTH WARDSCHENK
SECRETARY
537 CLOVER ST
REDLANDS CA 92373

Officer/Director/Trustee Four

ALBERTO MENDOZA
BOARD MEMBER
1530 CORNELL AVE
GLADSTONE OR 97027

Officer/Director/Trustee Five

KATHRYN BRIGHTBILL
BOARD MEMBER
1106 40TH ST W
BRADENTON FL 34205

Organization’s website ONESAFETYNET.COM
Organization’s email INFO@ONESAFETYNET.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/28/2014
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code R26 - Lesbian, Gay Rights
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence Yes
Compensation of Officer director trustee No
Donation of funds Yes
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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