FORM 1023-EZ for JEFFERSON PTA

Field Data
EIN 91-1144117
Case Number EO-2016043-000019
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JEFFERSON PTA
Organization’s Mailing Address 4302 NORTH 13TH STREET
City TACOMA
State WA
ZIP 98406
Accounting period End 12
Primary contact name DARBY VEECK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NICHOLE STRIVENS
CO-PRESIDENT
3108 N PROCTOR
TACOMA WA 98407

Officer/Director/Trustee Two

HEATHER RYDEEN
CO-PRESIDENT
4623 N 12TH ST
TACOMA WA 98406

Officer/Director/Trustee Three

SHARRON GLENN
TREASURER
1006 E 34TH ST
TACOMA WA 98404

Officer/Director/Trustee Four

DARBY VEECK
MEMBERSHIP COORDINATOR
1514 NORTH MASON AVE
TACOMA WA 98406-4314

Officer/Director/Trustee Five

JOANN MERRILL
SECRETARY
3017 N 10TH
TACOMA WA 98406

Organization’s website HTTP://JEFFERSONBRUINSPTA.ORG/
Organization’s email JEFFERSON.BRUINS.PTA@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/23/1981
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B94 - Parent/Teacher Group
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 Yes
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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