FORM 1023-EZ for DAVIS MIDDLE SCHOOL PTO

Field Data
EIN 46-3539511
Case Number EO-2015008-000145
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DAVIS MIDDLE SCHOOL PTO
Organization’s Mailing Address 8050 NORTH 129TH AVENUE
City OMAHA
State NE
ZIP 68142-1804
Accounting period End 7
Primary contact name LISA CARLSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LISA CARLSON
PTO PRESIDENT
6010 NORTH 166TH STREET
OMAHA NE 68116-3714

Officer/Director/Trustee Two

GEMA SIMMONS
PTO VICE PRESIDENT
14953 HANOVER STREET
BENNINGTON NE 68007-1519

Officer/Director/Trustee Three

MICHELLE KEHR
PTO TREASURER
6616 NORTH 110TH AVENUE
OMAHA NE 68164-1287

Officer/Director/Trustee Four

MELISSA GRAY
PTO SECRETARY
5618 NORTH 140TH AVENUE
OMAHA NE 68164-1287

Organization’s website
Organization’s email DAVISMIDDLEPTO@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/2013
Organization Incorporation State NE
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 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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