FORM 1023-EZ for THE MIKE TICE FOUNDATION
| Field | Data |
|---|---|
| EIN | 83-2870292 |
| Case Number | EO-2019029-000817 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | THE MIKE TICE FOUNDATION |
| Organization’s Mailing Address | 8350 164TH AVE NE |
| City | REDMOND |
| State | WA |
| ZIP | 98052-3813 |
| Accounting period End | 8 |
| Primary contact name | D EDSON CLARK |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
MICHAEL TICE
PRESIDENT
4840 E STATE ROUTE 302
BELFAIR WA 98529
Officer/Director/Trustee Two
DIANE TICE
VICE PRESIDENT
4840 E STATE ROUTE 202
BELFAIR WA 98529
Officer/Director/Trustee Three
D EDSON CLARK
TREASURER
PO BOX 3188
REDMOND WA 98073-3188
Officer/Director/Trustee Four
MIKE PEGRAM
DIRECTOR
958 HEAVENLY VIEW CT
GARDENERVILLE NV 85253
Officer/Director/Trustee Five
JACK BUSTON
DIRECTOR
21 FOREST GLEN LAKE SW
LAKEWOOD WA 98498
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 12/18/18 |
| 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: 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 | No |
| Benefit of College | No |
| Private Foundation 508(e) | Yes |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | D EDSON CLARK |
| Signature Title | TREASURER |
| Signature Date | 12/18/18 |
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