FORM 1023-EZ for PAROTID PATIENT PROJECT

Field Data
EIN 83-3083452
Case Number EO-2019065-000371
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PAROTID PATIENT PROJECT
Organization’s Mailing Address 150 SOUTH 5TH STREET STE 1200
City MINNEAPOLIS
State MN
ZIP 55402
Accounting period End 12
Primary contact name JESSICA BIRKEN ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL TESTOLIN
CHAIRMAN OF THE BOARD
150 SOUTH 5TH STREET STE 1200
MINNEAPOLIS MN 55402

Officer/Director/Trustee Two

JAMES J MARTIN
SECRETARY / TREASURER
150 SOUTH 5TH STREET STE 1200
MINNEAPOLIS MN 55402

Officer/Director/Trustee Three

KERRY OLSEN
DIRECTOR
150 SOUTH 5TH STREET STE 1200
MINNEAPOLIS MN 55402

Officer/Director/Trustee Four

JAMIE OLSON
DIRECTOR
150 SOUTH 5TH STREET STE 1200
MINNEAPOLIS MN 55402

Officer/Director/Trustee Five

GREGORY NELSON
DIRECTOR
150 SOUTH 5TH STREET STE 1200
MINNEAPOLIS MN 55402

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/13/18
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G40 - Diseases of Specific Organs
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 MICHAEL TESTOLIN
Signature Title CHAIRMAN OF THE BOARD
Signature Date 3/4/19

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