FORM 1023-EZ for THE FULLER FAMILY FOUNDATION

Field Data
EIN 83-1597600
Case Number EO-2018295-000033
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE FULLER FAMILY FOUNDATION
Organization’s Mailing Address 5015 SE 64TH AVE
City PORTLAND
State OR
ZIP 97206
Accounting period End 6
Primary contact name SHAWNA FULLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHAWNA FULLER
CHAIRMAN
5015 SE 64TH AVE
PORTLAND OR 97206

Officer/Director/Trustee Two

PHYLLIS SHELTON
TREASURER
1002 SE 50TH
PORTLAND OR 97215

Officer/Director/Trustee Three

KATHERINE SCHNEIDER
SECRETARY
6755 SE RAMONA ST
PORTLAND OR 97206

Officer/Director/Trustee Four

CAMERON FULLER
AT LARGE
5740 W CENTINELA AVE APT 121
LOS ANGELES CA 90045

Organization’s website
Organization’s email FULLERFAMILYARTSFOUNDATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/24/18
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T30 - Public Foundations
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 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 SHAWNA FULLER
Signature Title CHAIRMAN
Signature Date 10/18/18

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