FORM 1023-EZ for POSITIVE IMPACT OF OKLAHOMA

Field Data
EIN 47-4004438
Case Number EO-2015302-000212
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name POSITIVE IMPACT OF OKLAHOMA
Organization’s Mailing Address 200 HANNA DRIVE
City PONCA CITY
State OK
ZIP 74604-5764
Accounting period End 6
Primary contact name JENNIFER JOHNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARISA DYE
PRESIDENT
3 WOODMOOR PLACE
PONCA CITY OK 74604

Officer/Director/Trustee Two

JENNIFER JOHNSON
TREASURER
600 SHAMROCK CIRCLE
PONCA CITY OK 74601-1640

Officer/Director/Trustee Three

BETSY JOHNSON
VICE PRESIDENT
200 HANNA DRIVE
PONCA CITY OK 74604-5764

Officer/Director/Trustee Four

CHERLY KINKAID
SECRETARY
1001 NORTH 7TH STREET
PONCA CITY OK 74601

Officer/Director/Trustee Five

STEPHANIE BLUM
TECHNOLOGY CHAIR/MEMBER
813 EDGEWOOD DRIVE
PONCA CITY OK 74604

Organization’s website
Organization’s email POSTIVEIMPACTOK@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/1/2015
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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