FORM 1023-EZ for FOOTLOOSE FRIENDS

Field Data
EIN 61-1691272
Case Number EO-2016025-000377
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FOOTLOOSE FRIENDS
Organization’s Mailing Address PO BOX 220324
City PORTLAND
State OR
ZIP 97269-0324
Accounting period End 4
Primary contact name GREG KROLICKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GREGORY KROLICKI
PRESIDENT
PO BOX 220324
PORTLAND OR 97269-0324

Officer/Director/Trustee Two

ALLISON KROLICKI
TREASURER
PO BOX 220324
PORTLAND OR 97269-0324

Officer/Director/Trustee Three

EVA NIEHAUS
SECRETARY
14913 SE MILL PLAIN BLVD
VANCOUVER WA 98684

Officer/Director/Trustee Four

TIMOTHY MIDDLETON
DIRECTOR
13751 NW HOGAN ST
PORTLAND OR 97229

Officer/Director/Trustee Five

DEBORAH MIDDLETON
DIRECTOR
13751 NW HOGAN ST
PORTLAND OR 97229

Organization’s website FOOTLOOSEFRIENDS.ORG
Organization’s email INFO@FOOTLOOSEFRIENDS.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/23/2012
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A62 - Dance
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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