FORM 1023-EZ for INDEPENDENCE HIGH SCHOOL PTO

Field Data
EIN 84-2123475
Case Number EO-2019171-000255
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name INDEPENDENCE HIGH SCHOOL PTO
Organization’s Mailing Address 23115 LEARNING CIRCLE
City ASHBURG
State VA
ZIP 20148
Accounting period End 7
Primary contact name GERI WARDLOW
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TOM GURGANOUS
PRESIDENT
23115 LEARNING CIRCLE
ASHBURN VA 20148

Officer/Director/Trustee Two

CASEY FADGEN
VICE PRESIDENT
23115 LEARNING CIRCLE
ASHBURN VA

Officer/Director/Trustee Three

KAREN PFISTER
SECRETARY
23115 LEARNING CIRCLE
ASHBURN VA 20148

Officer/Director/Trustee Four

GERI WARDLOW
TREASURER
23115 LEARNING CIRCLE
ASHBURN VA 20148

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/16/19
Organization Incorporation State VA
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: No
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 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 GERI WARDLOW
Signature Title TREASURER
Signature Date 6/18/19

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