FORM 1023-EZ for LA PINE LIONS CLUB INC

Field Data
EIN 47-3740248
Case Number EO-2015111-000026
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LA PINE LIONS CLUB INC
Organization’s Mailing Address PO BOX 3241
City LA PINE
State OR
ZIP 97739
Accounting period End 6
Primary contact name SUZANNE T MOSE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DARRELL BENNETT
PRESIDENT
PO BOX 3241
LA PINE OR 97739

Officer/Director/Trustee Two

DAVID DRIGGERS
TREASURER
PO BOX 3241
LA PINE OR 97739

Officer/Director/Trustee Three

BETTY DRIGGERS
SECRETARY
PO BOX 3241
LA PINE OR 97739

Officer/Director/Trustee Four

GARY MOSE
VICE-PRESIDENT
PO BOX 3241
LA PINE OR 97739

Officer/Director/Trustee Five

BOB BENNETT
2ND VICE-PRESIDENT
PO BOX 3241
LA PINE OR 97739

Organization’s website HTTP://LAPINELIONSOR.LIONWAP.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/14/2015
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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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