FORM 1023-EZ for FRIENDS OF BASHA

Field Data
EIN 47-1733173
Case Number EO-2014258-000372
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FRIENDS OF BASHA
Organization’s Mailing Address 1193 ROYVONNE AVE SE SUITE 12
City SALEM
State OR
ZIP 97302
Accounting period End 12
Primary contact name ROBERT SEYFERT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

HOLLY HAMLIN
BOARD CHAIR
294 HRUBETZ RD SE
SALEM OR 97302

Officer/Director/Trustee Two

ROBERT SEYFERT
SEC-TREASUER
155 KASHMIR ST SE
SALEM OR 97306

Officer/Director/Trustee Three

NANCY SEYFERT
BOARD MEMBER
155 KASHMIR ST SE
SALEM OR 97306

Officer/Director/Trustee Four

ROBIN SALEM
BOARD MEMBER
155 KASHMIR ST SE
SALEM OR 97306

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/2/2014
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Q30 - International Development, Relief Services
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 Yes
Donation of funds No
Conducting Activities Outside of United States Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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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