FORM 1023-EZ for BEACON VILLAGE

Field Data
EIN 85-0671363
Case Number EO-2020237-000159
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BEACON VILLAGE
Organization’s Mailing Address 3317 SE WASHINGTON ST
City PORTLAND
State OR
ZIP 97214-3138
Accounting period End 6
Primary contact name MATT LEMBO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN MAYER
EXECUTIVE DIRECTOR
3317 SE WASHINGTON ST
PORTLAND OR 97214-3138

Officer/Director/Trustee Two

PATRICIA SCHWIEBERT
BOARD OF DIRECTORS
2116 NE 18TH AVE
PORTLAND OR 97212-4609

Officer/Director/Trustee Three

MATTHEW LEMBO
BOARD OF DIRECTORS
3843 SE TAYLOR STREET
PORTLAND OR 97214-4346

Officer/Director/Trustee Four

MICHAEL ELLICK
BOARD OF DIRECTORS
2116 NE 18TH AVE
PORTLAND OR 97212-4609

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/9/2020
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P85 - Homeless Persons Centers, Services
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 MATTHEW LEMBO
Signature Title BOARD OF DIRECTORS
Signature Date 8/20/2020

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