FORM 1023-EZ for BROOKINGS HARBOR COMMUNITY THEATER

Field Data
EIN 27-3690170
Case Number EO-2015002-000333
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BROOKINGS HARBOR COMMUNITY THEATER
Organization’s Mailing Address PO BOX 6172
City BROOKINGS
State OR
ZIP 97415-9998
Accounting period End 12
Primary contact name DORIS BLODGETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JACQUE GRAVES
PRESIDET
97925 HOLLY LANE
BROOKINGS OR 97415-9998

Officer/Director/Trustee Two

RANDY ROSE
VICE PRESIDENT
99779 F BANK CHETCO RIVER RD
BROOKINGS OR 97415-9998

Officer/Director/Trustee Three

SHAWNA LYNN
TREASURER
PO BOX 325
BROOKINGS OR 97415-9998

Officer/Director/Trustee Four

TRASEE ROSE
SECRETARY
99779 S BANK CHETCO RIVER RD
BROOKINGS OR 97415-9998

Officer/Director/Trustee Five

DORIS BLODGETT
DIRECTOR
PO BOX 7164
BROOKINGS OR 97415-9998

Organization’s website BROOKINGSHARBORCOMMUNITYTHEATER.COM
Organization’s email BH.COMMUNITYTHEATER@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/2008
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A60 - Performing Arts Organizations
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 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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