FORM 1023-EZ for TLCA PARENT ACTION COMMITTEE

Field Data
EIN 84-3766468
Case Number EO-2020071-000283
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TLCA PARENT ACTION COMMITTEE
Organization’s Mailing Address 12040 115TH AVE NE
City KIRKLAND
State WA
ZIP 98034
Accounting period End 12
Primary contact name KELLEY MENDONCA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMY LAI
CO-PRESIDENT
11024 128TH PL NE
KIRKLAND WA 98033

Officer/Director/Trustee Two

HOLLY PALAY
CO-PRESIDENT
13565 NE 202ND ST
WOODINVILLE WA 98072

Officer/Director/Trustee Three

KELLEY MENDONCA
TREASURER
716 3RD LN S
KIRKLAND WA 98033

Officer/Director/Trustee Four

JOYCE MAALOUF
CO-VP
10033 NE 125TH CT
KIRKLAND WA 98034

Officer/Director/Trustee Five

MIKA PRITCHARD-BERMAN
CO-COMMUNICATIONS SECRETARY
16416 3RD DR SE
BOTHELL WA 98012

Organization’s website HTTPS://WWW.FACEBOOK.COM/GROUPS/2528813587339452/
Organization’s email P.A.C.TOTEMLAKESCHOOL@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/1/2019
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: Yes
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 KELLEY MENDONCA
Signature Title TREASURER
Signature Date 3/9/2020

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