FORM 1023-EZ for EXTRA PASS BASKETBALL

Field Data
EIN 82-4665645
Case Number EO-2018264-000165
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EXTRA PASS BASKETBALL
Organization’s Mailing Address 16580 SE ROCK CREEK CT
City HAPPY VALLEY
State OR
ZIP 97015
Accounting period End 12
Primary contact name KELLY OBRIEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRISTOPHER AZORR
PRESIDENT
12013 SE 116TH CT
HAPPY VALLEY OR 97086

Officer/Director/Trustee Two

KELLY OBRIEN
SENIOR DIRECTOR
13379 SOUTHEAST WOODLAND CIRCLE
HAPPY VALLEY OR 97086

Officer/Director/Trustee Three

JENNIFER OBRIEN
SECRETARY
13379 SOUTHEAST WOODLAND CIRCLE
HAPPY VALLEY OR 97086

Officer/Director/Trustee Four

MATHEW GARLINGTON
VICE PRESIDENT
16580 SE ROCK CREEK CT
HAPPY VALLEY OR 97015

Officer/Director/Trustee Five

JODIE GARLINGTON
SENIOR DIRECTOR
165
HAPPY VALLEY OR 97015

Organization’s website EXTRAPASSBASKETBALL.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/21/18
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
Organization’s purpose Charitable: No
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 CHRISTOPHER AZORR
Signature Title PRESIDENT
Signature Date 9/19/18

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