FORM 1023-EZ for FREDERICKSON ELEMENTARY PTA 5 3 7

Field Data
EIN 27-0429294
Case Number EO-2017005-000270
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FREDERICKSON ELEMENTARY PTA 5 3 7
Organization’s Mailing Address 17418 74TH AVE E
City PUYALLYP
State WA
ZIP 98375-9747
Accounting period End 6
Primary contact name STEPHANIE SIMMONS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESSICA CARR
PRESIDENT
17418 74TH AVE E
PUYALLUP WA 98375-9747

Officer/Director/Trustee Two

VICTOR VILLAREAL
VICE PRESIDENT
17418 74TH AVE E
PUYALLUP WA 98375-9747

Officer/Director/Trustee Three

STEPHANIE SIMMONS
TREASURER
17418 74TH AVE E
PUYALLUP WA 98375-9747

Officer/Director/Trustee Four

MELODY CAMPBELL
SECRETARY
17418 74TH AVE E
PUYALLUP WA 98375-9747

Organization’s website
Organization’s email SSIMMONS1133@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/30/2009
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: 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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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