FORM 1023-EZ for PACIFIC OUTDOOR CLUB

Field Data
EIN 83-4179198
Case Number EO-2020062-000131
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PACIFIC OUTDOOR CLUB
Organization’s Mailing Address 13327 SE 248TH PL
City KENT
State WA
ZIP 98042
Accounting period End 12
Primary contact name PENG YU LIU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEY DONN
PRESIDENT
13327 SE 248TH PL
KENT WA 98042

Officer/Director/Trustee Two

LING LU
SECRETRAY
618 122ND AVENUE NE
BELLEVUE WA 98005

Officer/Director/Trustee Three

PENG YU LIU
TREASURER
4702 118TH AVENUE SE
BELLEVUE WA 98006

Officer/Director/Trustee Four

YUGUO LIU
DIRECTOR
9509 SE 68TH ST
MERCER ISLAND WA 98040

Officer/Director/Trustee Five

HONGBO SHAO
DIRECTOR
19621 216TH AVENUE NE
WOODINVILLE WA 98077

Organization’s website HTTPS://PACIFICOUTDOORCLUB.WIXSITE.COM//WINTER-SPORT
Organization’s email PACIFICOUTDOORCLUB@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/4/2019
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 KEY DONN
Signature Title PRESIDENT
Signature Date 2/27/2020

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