FORM 1023-EZ for ROOSEVELT ELEMENTARY PTO

Field Data
EIN 47-1122132
Case Number EO-2014363-000058
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROOSEVELT ELEMENTARY PTO
Organization’s Mailing Address 106 MONROE ROAD
City PORT ANGELES
State WA
ZIP 98362
Accounting period End 12
Primary contact name LENA WASHKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMI WOOD
DIRECTOR
106 MONROE ROAD
PORT ANGELES WA 98362

Officer/Director/Trustee Two

GABI JOHNSON
DIRECTOR
106 MONROE ROAD
PORT ANGELES WA 98362

Officer/Director/Trustee Three

JILL JARNIGAN
DIRECTOR
106 MONROE ROAD
PORT ANGELES WA 98362

Officer/Director/Trustee Four

JENNIFER DENTON
DIRECTOR
106 MONROE ROAD
PORT ANGELES WA 98362

Officer/Director/Trustee Five

APRIL SIBEL
DIRECTOR
106 MONROE ROAD
PORT ANGELES WA 98362

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/10/2014
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B94 - Parent/Teacher Group
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
Signature Title
Signature Date

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