FORM 1023-EZ for HIGH ALTITUDE TRACK AND FIELD CLUB

Field Data
EIN 82-5119945
Case Number EO-2018106-000522
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HIGH ALTITUDE TRACK AND FIELD CLUB
Organization’s Mailing Address 7223 RUTH DR
City KLAMATH FALLS
State OR
ZIP 97603-9809
Accounting period End 12
Primary contact name DOUGLAS WERNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DOUGLAS WERNER
PRESIDENT
7223 RUTH DR
KLAMATH FALLS OR 97603-9809

Officer/Director/Trustee Two

TYRA DICKINSON
TREASURER
5228 BRYANT AVE
KLAMATH FALLS OR 97603-5018

Officer/Director/Trustee Three

KARLEY GRANDY
SECRETARY
635 HANKS ST
KLAMATH FALLS OR 97601-1354

Officer/Director/Trustee Four

BROOKE GAGNEUR
DIRECTOR
7223 RUTH DR
KLAMATH FALLS OR 97603-9809

Officer/Director/Trustee Five

JEFF ELLIOTT
DIRECTOR
365 CRESTDALE WAY
KLAMATH FALLS OR 97603-3978

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/27/18
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TYRA DICKINSON
Signature Title TREASURER
Signature Date 4/10/18

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