FORM 1023-EZ for PORTLAND PAY IT FORWARD
| Field | Data |
|---|---|
| EIN | 84-4163564 |
| Case Number | EO-2020036-000210 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | PORTLAND PAY IT FORWARD |
| Organization’s Mailing Address | 201 COLLEGE ST |
| City | PORTLAND |
| State | TN |
| ZIP | 37148 |
| Accounting period End | 12 |
| Primary contact name | JUANITA KISSELL |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
JUANITA KISSELL
TREASURER
3541 HIGHWAY 25
COTTONTOWN TN 37048
Officer/Director/Trustee Two
ASHLEY ANDERSON
EXECUTIVE DIRECTOR
201 COLLEGE ST
PORTLAND TN 37148
Officer/Director/Trustee Three
BILLY DUNIVAN
CHAIRMAN OF THE BOARD
100 SOUTHFIELD DR
SPRINGFIELD TN 37172
Officer/Director/Trustee Four
LORA SIZER
SECRETARY
102 ARTHUR CT
PORTLAND TN 37148
Officer/Director/Trustee Five
NATALIE FULK
TRUSTEE
100 ARTHUR CT
PORTLAND TN 37148
| Organization’s website | WWW.PORTLANDPAYITFORWARD.ORG |
|---|---|
| Organization’s email | PORTLANDPAYITFORWARD@YAHOO.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/15/2020 |
| Organization Incorporation State | TN |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | K31 - Food Banks, Food Pantries |
| 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 | 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 | JUANITA KISSELL |
| Signature Title | TREASURER |
| Signature Date | 2/2/2020 |
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