FORM 1023-EZ for SANTA CLARA COMMUNITY FOUNDATION

Field Data
EIN 86-2194282
Case Number EO-2021274-000054
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SANTA CLARA COMMUNITY FOUNDATION
Organization’s Mailing Address 4792 HERMAN ST
City EUGENE
State OR
ZIP 97404
Accounting period End 12
Primary contact name DAVID E ATKIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIM FOELKER
PRESIDENT
4792 HERMAN ST
EUGENE OR 97404

Officer/Director/Trustee Two

JERRY MOHR
SECRETARY
PO BOX 10645
EUGENE OR 97440

Officer/Director/Trustee Three

HOWARD MALCOLM
TREASURER
4700 RIVER RD
EUGENE OR 97404

Officer/Director/Trustee Four

DARCY DAVIS
DIRECTOR
205 E ANCHOR AVE
EUGENE OR 97404

Officer/Director/Trustee Five

THOMAS DODD
DIRECTOR
371 LODENQUAI LANE
EUGENE OR 97404

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/25/2021
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: Yes
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 Yes
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 TIM FOELKER
Signature Title PRESIDENT
Signature Date 9/29/2021

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