FORM 1023-EZ for CHEWELAH VALLEY LAND TRUST

Field Data
EIN 83-1624371
Case Number EO-2018320-000218
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHEWELAH VALLEY LAND TRUST
Organization’s Mailing Address PO BOX 6
City CHEWELAH
State WA
ZIP 99109
Accounting period End 12
Primary contact name JACOB WILSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACOB WILSON
PRESIDENT
PO BOX 6
CHEWELAH WA 99109

Officer/Director/Trustee Two

RYAN SIEBER
VICE PRESIDENT
705 ROBERTS AVE
CHEWELAH WA 99109

Officer/Director/Trustee Three

AIMEE GENCE
TREASURER
PO BOX 10620
SPOKANE WA 99209

Officer/Director/Trustee Four

JANESSA GRAVES
SECRETARY
102 S STEVENS ST
CHEWELAH WA 99109

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/22/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C34 - Land Resources Conservation
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 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 JACOB WILSON
Signature Title PRESIDENT
Signature Date 11/14/18

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