FORM 1023-EZ for EMS COMMUNITY FOUNDATION

Field Data
EIN 83-2692264
Case Number EO-2019157-000321
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EMS COMMUNITY FOUNDATION
Organization’s Mailing Address PO BOX 10911
City EUGENE
State OR
ZIP 97440-2911
Accounting period End 12
Primary contact name IAN T RICHARDSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALLAN BENAVIDES
PRESIDENT, DIRECTOR
2425 WILSON DR
EUGENE OR 97405-1473

Officer/Director/Trustee Two

ANNE CULHANE
VICE PRESIDENT, DIRECTOR
1050 FERRY ST APT 405A
EUGENE OR 97401-3336

Officer/Director/Trustee Three

MATT DOMPE
TREASURER, DIRECTOR
1326 PIPER LN
EUGENE OR 97401-7807

Officer/Director/Trustee Four

AMY NEWPORT
SECRETARY, DIRECTOR
1497 MCCARTHY WAY
EUGENE OR 97402-1785

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/1/18
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
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 Yes
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ALLAN BENAVIDES
Signature Title PRESIDENT, DIRECTOR
Signature Date 6/4/19

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