FORM 1023-EZ for SELFID

Field Data
EIN 81-3103067
Case Number EO-2016187-000398
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SELFID
Organization’s Mailing Address 2520 CEDAR COVE RD
City LINCOLN
State NE
ZIP 68507
Accounting period End 6
Primary contact name ASHLEY WOOD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ASHLEY WOOD
CHIEF EXECUTIVE OFFICER
2520 CEDAR COVE RD
LINCOLN NE 68507

Officer/Director/Trustee Two

BRANDON PETERSON
CHIEF OPERATIONS OFFICER
9420 COLBY ST
LINCOLN NE 68505

Officer/Director/Trustee Three

KAYLA OTT
CHIEF COMMUNICATIONS OFFICER
7414 N 75TH ST
OMAHA NE 68122

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/24/2016
Organization Incorporation State NE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
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 Yes
One Third Support Gifts No
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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