FORM 1023-EZ for NWA PI INC

Field Data
EIN 47-4259732
Case Number EO-2015212-000478
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NWA PI INC
Organization’s Mailing Address 114 S COLLEGE AVENUE SUITE C
City FAYETTEVILLE
State AR
ZIP 72701
Accounting period End 12
Primary contact name DEBBY WINTERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DILLON DOOMS
DIRECTOR
1112 CHARCERY LANE
CAVE SPRINGS AR 72718

Officer/Director/Trustee Two

BRENNA BLACKWELL
DIRECTOR
1359 N CADDO AVE
FAYETTEVILLE AR 72704

Officer/Director/Trustee Three

DEBBY WINTERS
DIRECTOR
114 S COLLEGE AVENUE SUITE C
FAYETTEVILLE AR 72701

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/12/2015
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B90 - Educational Services and Schools - Other
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 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
Signature Title
Signature Date

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