FORM 1023-EZ for ORCHARDS EVERGREEN LIONS FOUNDATION

Field Data
EIN 46-1253497
Case Number EO-2016217-000245
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ORCHARDS EVERGREEN LIONS FOUNDATION
Organization’s Mailing Address PO BOX 820134
City VANCOUVER
State WA
ZIP 98682
Accounting period End 6
Primary contact name JACK ROBINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JIM TERRELL
PRESIDENT
1702 SW MAWRCREST AVE
GRESHAM OR 97080

Officer/Director/Trustee Two

MARY JARSON
SECRETARY
10021 NE 246TH CIRCLE
BATTLE GROUND WA 98604

Officer/Director/Trustee Three

JACK ROBINS
TREASURER
4705 NE 151ST AVE
VANCOUVER WA 98682

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/2012
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T30 - Public Foundations
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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