FORM 1023-EZ for CLACKAMAS COUNTY BAR FOUNDATION

Field Data
EIN 82-4688975
Case Number EO-2018284-000250
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CLACKAMAS COUNTY BAR FOUNDATION
Organization’s Mailing Address 821 MAIN STREET ROOM 101
City OREGON CITY
State OR
ZIP 97045-1843
Accounting period End 12
Primary contact name RODERICK BOUTIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RODERICK BOUTIN
DIRECTOR
4900 MEADOWS RD NO 300
LAKE OSWEGO OR 97035

Officer/Director/Trustee Two

ANGELA LAIDLAW
DIRECTOR
1001 MOLALLA AVE NO 208
OREGON CITY OR 97045

Officer/Director/Trustee Three

HAFEZ DARAEE
DIRECTOR
7455 BRIDGEPORT RD NO 205
TIGARD OR 97224

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/31/17
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T12 - 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 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 RODERICK BOUTIN
Signature Title DIRECTOR
Signature Date 10/9/18

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