FORM 1023-EZ for PASCO AREA SAFE COMMUNITY ORGANIZATION

Field Data
EIN 82-1515856
Case Number EO-2018120-000476
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PASCO AREA SAFE COMMUNITY ORGANIZATION
Organization’s Mailing Address 525 N 3RD AVENUE
City PASCO
State WA
ZIP 99301
Accounting period End 12
Primary contact name DAVID DILLSWORTH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID DILLSWORTH
PRESIDENT
505 N ROAD 40
PASCO WA 99301

Officer/Director/Trustee Two

JOSHUA CAMP
VICE-PRESIDENT
53111 VALDEZ LANE
PASCO WA 99301

Officer/Director/Trustee Three

LYDIA DILLSWORTH
SECRETARY
1304 N 37TH COURT
PASCO WA 99301

Officer/Director/Trustee Four

TRACY GOETZ
TREASURER
3906 MONTGOMERY LANE
PASCO WA 99301

Organization’s website
Organization’s email PASCOAREASAFECOMMUNITYORG@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/1/16
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W24 - Citizen Participation
Organization’s purpose Charitable: No
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 DAVID DILLSWORTH
Signature Title PRESIDENT
Signature Date 4/26/18

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