FORM 1023-EZ for CENTER FOR INDIGENOUS SELF DETERMINATION RESEARCH
| Field | Data |
|---|---|
| EIN | 81-3022138 |
| Case Number | EO-2017011-000385 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | CENTER FOR INDIGENOUS SELF DETERMINATION RESEARCH |
| Organization’s Mailing Address | 85529 DILLEY LN |
| City | EUGENE |
| State | OR |
| ZIP | 97405 |
| Accounting period End | 12 |
| Primary contact name | KEVIN BOURGAULT |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
KEVIN BOURGAULT
EXECUTIVE DIRECTOR
85529 DILLEY LN
EUGENE OR 97405-9648
Officer/Director/Trustee Two
TINA JACKSON
CHAIRPERSON
21311 SISTER SKY LN NE
INDIANOLA WA 98342-9706
Officer/Director/Trustee Three
LALENA AMIOTTE
VICE CHAIRPERSON
PO BOX 791
HOODSPORT WA 98548-0791
Officer/Director/Trustee Four
BRIAN KLOPOTEK
TREASURER
850 E 36TH AVE
EUGENE OR 97405-4351
Officer/Director/Trustee Five
DEBORAH OLSON
SECRETARY
1755 W 25TH AVE
EUGENE OR 97405-1609
| Organization’s website | WWW.CISDR.ORG |
|---|---|
| Organization’s email | CONTACT@CISDR.ORG |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 6/22/2016 |
| Organization Incorporation State | OR |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | B99 - Education N.E.C. |
| Organization’s purpose | Charitable: No 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 | No |
| Benefit of College | No |
| Private Foundation 508(e) | Yes |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | |
| Signature Title | |
| Signature Date |
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