FORM 1023-EZ for THE POTATO HEAD PROJECT

Field Data
EIN 81-2679498
Case Number EO-2016165-000417
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE POTATO HEAD PROJECT
Organization’s Mailing Address 7700 188TH LN NW
City NOWTHEN
State MN
ZIP 55303
Accounting period End 12
Primary contact name JENNIFER URBAN - CAF NO 0308-14263R
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KRISTIN MOAN
PRESIDENT + DIRECTOR
7700 188TH LN NW
NOWTHEN MN 55303

Officer/Director/Trustee Two

AMY DUCHENE
TREASURER + DIRECTOR
3100 11TH AVE S
MINNEAPOLIS MN 55407

Officer/Director/Trustee Three

HEIDI FOSTER
SECRETARY + DIRECTOR
1403 COUNTY ROAD GG
NEW RICHMOND WI 54017

Organization’s website WWW.THEPOTATOHEADPROJECT.ORG
Organization’s email THEPOTATOHEADPROJECT@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/21/2016
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other 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 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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