FORM 1023-EZ for FOREST GROVE UNCORKED

Field Data
EIN 47-1688012
Case Number EO-2014266-000154
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FOREST GROVE UNCORKED
Organization’s Mailing Address 1021 34TH PL
City FOREST GROVE
State OR
ZIP 97116-3141
Accounting period End 10
Primary contact name DAWN HOUSER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DAWN HOUSER
BOARD CHAIR
1021 34TH PL
FOREST GROVE OR 97116-3141

Officer/Director/Trustee Two

GARY Houser
VICE CHAIR
1021 34th Pl
Forest Grove OR 97116-3141

Officer/Director/Trustee Three

CATHI BAAS
VICE CHAIR
14450 NW PARSON RD
FOREST GROVE OR 97116-3141

Officer/Director/Trustee Four

CAITLYN BAAS-FORD
SECRETARY
1021 34th Pl
Forest Grove OR 97116-3141

Organization’s website WWW.FGUNCORKED.COM
Organization’s email FGUNCORKED@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/26/2014
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 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
Signature Title
Signature Date

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