| Field | Data |
|---|---|
| EIN | 83-2754524 |
| Case Number | EO-2019029-000240 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | PERIPHERIAL VISION PDX |
| Organization’s Mailing Address | 4929 SE 113TH AVE |
| City | PORTLAND |
| State | OR |
| ZIP | 97203 |
| Accounting period End | 12 |
| Primary contact name | SEBASTIAN ROGERS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
SEBASTIAN ROGERS
PRESIDENT
4929 SE 113TH AVE
PORTLAND OR 97217
ERIC KNOX
CHAIR
2208 NE 128TH AVE
PORTLAND OR 97230
MICHELLE JONES
BOARD MEMBER
1302 SE ANKENY ST
1302 SE ANKENY ST OR 97214
MATTHEW TAMURA
BOARD MEMBER
7911 SE CARLTON ST
PORTLAND OR 97206
MARCY BRADLEY
BOARD MEMBER
12215 NE MARX ST
PORTLAND OR 97230
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 12/7/18 |
| Organization Incorporation State | OR |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | A20 - Arts, Cultural Organizations - Multipurpose |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes Scientific: Yes Literary: Yes 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 | SEBASTIAN ROGERS |
| Signature Title | PRESIDENT |
| Signature Date | 12/17/18 |
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