FORM 1023-EZ for PORTLAND FAMILY FOUNDATION

Field Data
EIN 47-3934820
Case Number EO-2015135-000078
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PORTLAND FAMILY FOUNDATION
Organization’s Mailing Address 6320 SW MACADAM AVENUE
City PORTLAND
State OR
ZIP 97239
Accounting period End 12
Primary contact name JAMES FISHBACK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JACK TODARO
MEMBER AT LARGE
6320 SW MACADAM AVENUE
PORTLAND OR 97239

Officer/Director/Trustee Two

SHARI JACOBSON
MEMBER AT LARGE
6320 SW MACADAM AVENUE
PORTLAND OR 97239

Officer/Director/Trustee Three

MELISSA KNIAZEVA
MEMBER AT LARGE
6320 SW MACADAM AVENUE
PORTLAND OR 97239

Officer/Director/Trustee Four

BRAD JOHNSON
MEMBER AT LARGE
6320 SW MACADAM AVENUE
PORTLAND OR 97239

Officer/Director/Trustee Five

JAMES FISHBACK
MEMBER AT LARGE
6320 SW MACADAM AVENUE
PORTLAND OR 97239

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/27/2015
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O12 - Fund Raising and/or Fund Distribution
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 Yes
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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