FORM 1023-EZ for 2ND SHOT NORTH WEST INC

Field Data
EIN 84-2535437
Case Number EO-2019246-000287
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name 2ND SHOT NORTH WEST INC
Organization’s Mailing Address 1560 SW WYNWOOD AVE
City PORTLAND
State OR
ZIP 97225
Accounting period End 12
Primary contact name MICHAEL DAVIDSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL DAVIDSON
PRESIDENT, DIRECTOR
1560 SW WYNWOOD AVE
PORTLAND OR 97225

Officer/Director/Trustee Two

DAVE GREEN
SECRETARY, DIRECTOR
20020 MCCONNELL DR
BEND OR 97703

Officer/Director/Trustee Three

ROLAND HOWARD
TREASURER, DIRECTOR
715 NW 178TH
BEAVERTON OR 97007

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/26/19
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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 MICHAEL DAVIDSON
Signature Title PRESIDENT, DIRECTOR
Signature Date 8/30/19

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