FORM 1023-EZ for ELEOS INC

Field Data
EIN 46-1425119
Case Number EO-2016118-000082
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ELEOS INC
Organization’s Mailing Address 4785 WHITMAN CIRCLE NE
City SALEM
State OR
ZIP 97305
Accounting period End 12
Primary contact name HAROLD MOORE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

HAROLD MOORE
CEO
4785 WHITMAN CIRCLE NE
SALEM OR 97305

Officer/Director/Trustee Two

DAVID RICE
SECRETARY
PO BOX 128
SILVERTON OR 97381

Officer/Director/Trustee Three

BOB FRITTS
TREASURER
1101 PINE ST
SILVERTON OR 97381

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/21/2012
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - 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 Yes
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
Signature Title
Signature Date

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