FORM 1023-EZ for PACK 134 ASSOCIATION

Field Data
EIN 47-5419972
Case Number EO-2016272-000251
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PACK 134 ASSOCIATION
Organization’s Mailing Address 868 GRAVENSTEIN HIGHWAY NORTH
City SEBASTOPOL
State CA
ZIP 95472
Accounting period End 6
Primary contact name BRIAN JACOBS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRIAN JACOBS
TREASURER
868 GRAVENSTEIN HWY NORTH
SEBASTOPOL CA 95472

Officer/Director/Trustee Two

JOE HORAK
SECRETARY
868 GRAVENSTEIN HWY NORTH
SEBASTOPOL CA 95472

Officer/Director/Trustee Three

DAVE SMILIE
PRESIDENT
868 GRAVENSTEIN HWY NORTH
SEBASTOPOL CA 95472

Officer/Director/Trustee Four

GREG CHIDISTER
VICE-PRESIDENT
868 GRAVENSTEIN HWY NORTH
SEBASTOPOL CA 95472

Officer/Director/Trustee Five

DOUG BRAIK
MEMBER
868 GRAVENSTEIN HWY NORTH
SEBASTOPOL CA 95472

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/18/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O41 - Boy Scouts of America
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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