FORM 1023-EZ for JEFFERSON STATE FOUR WHEEL DRIVE ASSOCIATION
| Field | Data |
|---|---|
| EIN | 46-5710694 |
| Case Number | EO-2016077-000040 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | JEFFERSON STATE FOUR WHEEL DRIVE ASSOCIATION |
| Organization’s Mailing Address | P O BOX 2044 |
| City | WHITE CITY |
| State | OR |
| ZIP | 97503 |
| Accounting period End | 12 |
| Primary contact name | JASON VALENTINO |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
Officer/Director/Trustee One
JASON VALENTINO
PRESIDENT
2389 BELL COURT APT 35
MEDFORD OR 97504
Officer/Director/Trustee Two
DUSTIN HAGGLUND
VICE PRESIDENT
389 SARDINE CREEK ROAD
GOLD HILL OR 97525
Officer/Director/Trustee Three
LEE MERWIN
SECRETARY
2030 BROOKHURST UNIT 49
MEDFORD OR 97504
Officer/Director/Trustee Four
SARA HUTCHISON
TREASURER
2590 LEONARD ROAD
GRANTS PASS OR 97527
Officer/Director/Trustee Five
DANIEL GOLDSMITH
BOARD MEMBER
2700 FALCON STREET UNIT 90
WHITE CITY OR 97502
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 5/20/2014 |
| Organization Incorporation State | OR |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | C99 - Environmental Quality, Protection, and Beautification 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 | 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 | Yes |
| One Third Support Gifts | No |
| 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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