FORM 1023-EZ for BREAKING THE SILENCE

Field Data
EIN 81-3575111
Case Number EO-2016298-000424
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BREAKING THE SILENCE
Organization’s Mailing Address 400 SW 2ND STREET
City MCMINNVILLE
State OR
ZIP 97128
Accounting period End 12
Primary contact name TERRY ATWOOD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TERRY ATWOOD
PRESIDENT
400 SW 2ND STREET
MCMINNVILLE OR 97128

Officer/Director/Trustee Two

SHANE CLEMMER
VICE PRESIDENT
508 SW BILLS STREET
MCMINNVILLE OR 97128

Officer/Director/Trustee Three

HAILEY LANDRY
TREASURER
400 SW 2ND STREET
MCMINNVILLE OR 97128

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/11/2016
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 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
Signature Title
Signature Date

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