FORM 1023-EZ for THE ARTS AND TECHNOLOGY INSTITUTE FOR SOCIAL INNOVATION

Field Data
EIN 86-1661800
Case Number EO-2021091-000732
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE ARTS AND TECHNOLOGY INSTITUTE FOR SOCIAL INNOVATION
Organization’s Mailing Address 2456 E STREET
City WASHOUGAL
State WA
ZIP 98671
Accounting period End 12
Primary contact name SYDNEY-ELISE MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SYDNEY-ELISE MILLER
EXECUTIVE DIRECTOR
2456 E STREET
WASHOUGAL WA 98671

Officer/Director/Trustee Two

CARL PETERSON
ASSISTANT DIRECTOR
2456 E STREET
WASHOUGAL WA 98671

Officer/Director/Trustee Three

KATIE HEATER
BUSINESS MANAGER
5948 WEST MINARETS AVENUE
FRESNO CA 93723

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/21/2021
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S99 - Community Improvement, Capacity Building N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: Yes
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 SYDNEY-ELISE MILLER
Signature Title EXECUTIVE DIRECTOR
Signature Date 2/22/2021

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