FORM 1023-EZ for PORTLAND SAA INTERGROUP

Field Data
EIN 72-1619915
Case Number EO-2019148-000402
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PORTLAND SAA INTERGROUP
Organization’s Mailing Address PO BOX 14708
City PORTLAND
State OR
ZIP 97293
Accounting period End 12
Primary contact name RICHARD EUGENE IPSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICHARD IPSEN
TREASURER
UNIT 2003
PORTLAND OR 97201-3545

Officer/Director/Trustee Two

BRENT MCCARTER
OFFICER
7061 N UNIVERSITY AVE
PORTLAND OR 97203-4756

Officer/Director/Trustee Three

GARY THILL
PRESIDENT
1031 NE HANCOCK ST
PORTLAND OR 97212

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/3/17
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F50 - Addictive Disorders 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 RICHARD IPSEN
Signature Title TREASURER
Signature Date 5/23/19

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