FORM 1023-EZ for FRIENDS OF GERVAIS FFA

Field Data
EIN 47-4236936
Case Number EO-2015208-000324
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FRIENDS OF GERVAIS FFA
Organization’s Mailing Address PO BOX 9195
City BROOKS
State OR
ZIP 97305
Accounting period End 12
Primary contact name BRENT LAFOLLETTE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BRENT LAFOLLETTE
PRESIDENT
3650 CLAUSEN ACRES LANE NE
SALEM OR 97303

Officer/Director/Trustee Two

JEREMIAH KOOP
VICE PRESIDENT
6221 BROPOJLAKE ROAD
BROOKS OR 97305

Officer/Director/Trustee Three

MARIA KIRK
SECRETARY
4041 MATHENY ROAD NE
GERVAIS OR 97026

Officer/Director/Trustee Four

MOLLY MCCARGER
TREASURER
12223 RIVER ROAD NE
GERVAIS OR 97026

Officer/Director/Trustee Five

TONY TESCH
REPORTER
26450 NE BELL ROAD
NEWBERG OR 97132

Organization’s website ALUMNI-GERVAISFFA.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/22/2015
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O12 - Fund Raising and/or Fund Distribution
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 Yes
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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