FORM 1023-EZ for POWER ON WITH LIMB LOSS

Field Data
EIN 81-3671544
Case Number EO-2017073-000139
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name POWER ON WITH LIMB LOSS
Organization’s Mailing Address 1048 LAUREL AVE
City SPRINGFIELD
State OR
ZIP 97478
Accounting period End 12
Primary contact name PAULA FREE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAULA FREE
PRESIDENT, SECRETARY, TREASURER
1048 LAUREL AVE
SPRINGFIELD OR 97478

Officer/Director/Trustee Two

RODNEY FREE
DIRECTOR
1048 LAUREL AVE
SPRINGFIELD OR 97478

Officer/Director/Trustee Three

DEBBIE ZAVALA
DIRECTOR
2071 COSMOLEDO STREET
EUGENE OR 97402

Officer/Director/Trustee Four

IRENE HEALY
DIRECTOR
89 E STREET NE
EPHRATA WA 98823

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/31/2016
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
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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