FORM 1023-EZ for COVERED INC
| Field | Data |
|---|---|
| EIN | 83-2205353 |
| Case Number | EO-2018295-000401 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | COVERED INC |
| Organization’s Mailing Address | 1541 NE HOLMAN ST |
| City | PORTLAND |
| State | OR |
| ZIP | 97211 |
| Accounting period End | 12 |
| Primary contact name | NURAL WILLIS JR |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
SANDRA MCDANIEL
CHAIR
10305 NW FORESTVIEW WAY
PORTLAND OR 97229
Officer/Director/Trustee Two
ESTENA SIMMS
BOARD MEMBER
5902 NE 11TH AVE
PORTLAND OR 97211
Officer/Director/Trustee Three
BEN LICHTENWALD
BOARD MEMBER
10211 N LOMBARD ST APT 3
PORTLAND OR 97203
Officer/Director/Trustee Four
NURAL WILLIS JR
PRESIDENT/CEO
1541 NE HOLMAN ST
PORTLAND OR 97211
Officer/Director/Trustee Five
BARON WILLIAMS
BOARD MEMBER
8832 N SYRACUSE ST
PORTLAND OR 97203
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/15/18 |
| Organization Incorporation State | OR |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P20 - Human Service Organizations - Multipurpose |
| 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 | No |
| One Third Support Gifts | No |
| Benefit of College | No |
| Private Foundation 508(e) | Yes |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | NURAL WILLIS JR |
| Signature Title | PRESIDENT/CEO |
| Signature Date | 10/19/18 |
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