FORM 1023-EZ for CULVER BULLDOG BOOSTER CLUB

Field Data
EIN 91-1836569
Case Number EO-2014232-000167
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CULVER BULLDOG BOOSTER CLUB
Organization’s Mailing Address 13004 SW GREEN DR
City CULVER
State OR
ZIP 97734
Accounting period End 8
Primary contact name DIANNA LEWIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SCOTT LEEPER
PRESIDENT
5420 SW MACY LN
CULVER OR 97734

Officer/Director/Trustee Two

BRAD KUDLAC
VICE PRESIDENT
785 SE HOLLY ST
PRINEVILLE OR 97754

Officer/Director/Trustee Three

ANGI LEEPER
SECRETARY
5420 SW MACY LN
CULVER OR 97734

Officer/Director/Trustee Four

DIANNA LEWIS
TREASURER
13004 SW GREEN DR
CULVER OR 97734

Organization’s website
Organization’s email DLEWIS.NNH@HOTMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/17/1997
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N11 - Single Organization Support
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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