FORM 1023-EZ for ROSE CITY KAPPA FOUNDATION

Field Data
EIN 82-3153821
Case Number EO-2017304-000056
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROSE CITY KAPPA FOUNDATION
Organization’s Mailing Address 17340 SW BILES LANE
City BEAVERTON
State OR
ZIP 97003
Accounting period End 10
Primary contact name ROYCE WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RUBEN MILLER
PRESIDENT
505 NW 87TH TERRACE
PORTLAND OR 97229

Officer/Director/Trustee Two

REGINALD NICHOLS
SECRETARY
10050 SE CLEONE CT
HAPPY VALLEY OR 97086

Officer/Director/Trustee Three

ALISTAR ROLLE
VICE-PRESIDENT
16330 NW LYNDEL
BEAVERTON OR 97006

Officer/Director/Trustee Four

ROYCE WILLIAMS
DIRECTOR
17340 SW BILES LANE
BEAVERTON OR 97003

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/24/2017
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B80 - Student Services, Organizations of Students
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 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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