FORM 1023-EZ for PAVONES PERMACULTURE PROJECT

Field Data
EIN 81-1666574
Case Number EO-2016253-000306
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PAVONES PERMACULTURE PROJECT
Organization’s Mailing Address 705 NORTH STATE STREET STE 137
City UKIAH
State CA
ZIP 95482
Accounting period End 12
Primary contact name DAVID ATKIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VANESSA CARTER
PRESIDENT
705 NORTH STATE STREET STE 137
UKIAH CA 95482

Officer/Director/Trustee Two

URSA GORSAK
TREASURER/SECRETARY
705 NORTH STATE STREET STE 137
UKIAH CA 95482

Officer/Director/Trustee Three

KATHRYN BERGLUND
DIRECTOR
705 NORTH STATE STREET STE 137
UKIAH CA 95482

Officer/Director/Trustee Four

JUSTIN ROSEBERRY
DIRECTOR
705 NORTH STATE STREET STE 137
UKIAH CA 95482

Officer/Director/Trustee Five

HANNAH JERMSTAD
DIRECTOR
705 NORTH STATE STREET STE 137
UKIAH CA 95482

Organization’s website
Organization’s email TRUBIZZ37@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/18/2015
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C99 - Environmental Quality, Protection, and Beautification N.E.C.
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 Yes
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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