FORM 1023-EZ for CASCADE CHAUTAUQUA

Field Data
EIN 81-2395404
Case Number EO-2016119-000374
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CASCADE CHAUTAUQUA
Organization’s Mailing Address 3570 SW RIVER PARKWAY SUITE 1411
City PORTLAND
State OR
ZIP 97239
Accounting period End 12
Primary contact name KIMBERLY R BURKLAND PRAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

STEVEN NOUSEN
PRESIDENT
3570 SW RIVER PARKWAY SUITE 1411
PORTLAND OR 97239

Officer/Director/Trustee Two

KELLY HARMS
SECRETARY
26200 S HARMS ROAD
CANBY OR 97013

Officer/Director/Trustee Three

PATRICIA HARMS
TREASURER
3570 SW RIVER PARKWAY SUITE 1411
PORTLAND OR 97239

Organization’s website CASCADECHAUTAUQUA.ORG
Organization’s email STEVEN1776@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/13/2016
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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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