FORM 1023-EZ for WESTERN MONARCH ADVOCATES

Field Data
EIN 83-3708190
Case Number EO-2019129-000214
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WESTERN MONARCH ADVOCATES
Organization’s Mailing Address 2499 HAPPY VALLEY DRIVE
City MEDFORD
State OR
ZIP 97501
Accounting period End 12
Primary contact name ROBERT A COFFAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT A COFFAN
PRESIDENT
2499 HA
MEDFORD OR 97501

Officer/Director/Trustee Two

A CELESTE NIESEN
VICE PRESIDENT
1681 WILD CANARY ST
MCKINLEYVILLE CA 95519

Officer/Director/Trustee Three

ANGELA BERGELT
SEC/TREAS
3955 S STAGE RD LOT 92
MEDFORD OR 97501

Officer/Director/Trustee Four

AMANDA EGERTSON
DIRECTOR
2974 NE ALPINE PEAKS PLACE
BEND OR 97701

Officer/Director/Trustee Five

TOM LANDIS
DIRECTOR
3248 SYCAMORE WAY
MEDFORD OR 97504

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/25/19
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D31 - Protection of Endangered Species
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 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 ROBERT A COFFAN
Signature Title PRESIDENT
Signature Date 5/7/19

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