FORM 1023-EZ for ARTFORMA

Field Data
EIN 81-5021209
Case Number EO-2017048-000090
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ARTFORMA
Organization’s Mailing Address 16029 NE 95TH CT
City REDMOND
State WA
ZIP 98052
Accounting period End 10
Primary contact name DEANNA FALCONE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEANNA FALCONE
EXECUTIVE DIRECTOR/ PRESIDENT
16029 NE 95TH CT
REDMOND WA 98052

Officer/Director/Trustee Two

TAMAR ALSBERG
VICE PRESIDENT CREATIVE DIRECTO/
3619 262 AVE SE
SAMMAMISH WA 98075

Officer/Director/Trustee Three

MELISSA ROGERS
TREASURER
16924 NE 97TH STT
REDMOND WA 98052

Officer/Director/Trustee Four

MEREDITH CAIN
VICE PRESIDENT/ GALLERY DIRECTOR
19200 NE 143RD PL
WOODINVILLE WA 98077

Officer/Director/Trustee Five

MARIANNE SRIVNER
SECRETARY
16921 NE 97TH ST
REDMOND WA 98052

Organization’s website WWW.ARTFORMA.ORG
Organization’s email DEDE@ARTFORMA.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/20/2016
Organization Incorporation State WA
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: 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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