FORM 1023-EZ for GRASSROOTS DATAWORKS

Field Data
EIN 82-4000244
Case Number EO-2018120-000639
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GRASSROOTS DATAWORKS
Organization’s Mailing Address 216 RIDGEMONT DRIVE
City EAST WENATCHEE
State WA
ZIP 98802
Accounting period End 12
Primary contact name SARAH SHAFFER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SARAH SHAFFER
PRESIDENT/DIRECTOR
1512 REX ROAD
WENATCHEE WA 98801

Officer/Director/Trustee Two

MATTHEW RAHKONEN
VICE PRESIDENT/TREASURER/DIRECTOR
2610 164TH ST SW NO A502
LYNNWOOD WA 98087

Officer/Director/Trustee Three

DAWNETTE THOMAS
SECRETARY/DIRECTOR
177 S KENT PLACE
EAST WENATCHEE WA 98802

Organization’s website WWW.GRASSROOTSDATAWORKS.ORG
Organization’s email LACY@GRASSROOTSDATAWORKS.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/9/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code U41 - Computer Science
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 SARAH SHAFFER
Signature Title PRESIDENT/DIRECTOR
Signature Date 4/27/18

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