FORM 1023-EZ for OPTIMIST FOUNDATION OF ALBANY OREGON

Field Data
EIN 82-1158806
Case Number EO-2017163-000415
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name OPTIMIST FOUNDATION OF ALBANY OREGON
Organization’s Mailing Address P O BOX 61
City ALBANY
State OR
ZIP 97321
Accounting period End 12
Primary contact name MICHAEL RANSOM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES STOM
PRESIDENT
1208 29TH AVE SE
ALBANY OR 97322

Officer/Director/Trustee Two

MICHAEL RANSOM
SECRETARY
1416 28TH AVE SE
ALBANY OR 97321

Officer/Director/Trustee Three

ANDREA HAMPL
TREASURER
32123 TANGENT DRIVE
TANGENT OR 97389

Organization’s website
Organization’s email ALBANYOPTIMISTCLUB@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/8/2017
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O12 - Fund Raising and/or Fund Distribution
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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