FORM 1023-EZ for MEDFORD WATER POLO CLUB

Field Data
EIN 93-1261303
Case Number EO-2017096-000378
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MEDFORD WATER POLO CLUB
Organization’s Mailing Address 2305C ASHLAND STREET NUMBER 169
City ASHLAND
State OR
ZIP 97520-3777
Accounting period End 12
Primary contact name MARIA A HOKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARIA A HOKE
PRESIDENT
2305C ASHLAND STREET NUMBER 169
ASHLAND OR 97520-3777

Officer/Director/Trustee Two

MARY BABB
VICE-PRESIDENT
763 MARSHALL AVENUE
MEDFORD OR 97501-4075

Officer/Director/Trustee Three

SUE BUCKINGHAM
SECRETARY
2466 HAPPY VALLEY DRIVE
MEDFORD OR 97501-4561

Officer/Director/Trustee Four

LIZ SIBERT
TREASURER
1032 KAMERIN SPRINGS ROAD
TALENT OR 97540-7842

Officer/Director/Trustee Five

JENNIFER DELSMAN
BOARD MEMBER
1042 GARFIELD STREET
MEDFORD OR 97501-3937

Organization’s website MEDFORDWATERPOLOCLUB.COM
Organization’s email MEDFORDWATERPOLOCLUB@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/1999
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: No
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 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
Signature Title
Signature Date

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