FORM 1023-EZ for MOLALLA CLAYS

Field Data
EIN 82-2082794
Case Number EO-2017191-000363
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOLALLA CLAYS
Organization’s Mailing Address 36004 S KUBAN RD
City MOLALLA
State OR
ZIP 97038
Accounting period End 12
Primary contact name JAMES PHILLIPS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES PHILLIPS
SECRETARY
35466 S FIRWOOD LN
MOLALLA OR 97038

Officer/Director/Trustee Two

GREGORY MILLER
PRESIDENT
36004 S KUBAN ROAD
MOLALLA OR 97038

Officer/Director/Trustee Three

KARLA JAZDINSKI
DIRECTOR
28950 SOUTH BEAVER CREEK ROAD
MULINO OR 97042

Officer/Director/Trustee Four

AMY HARRINGTON
DIRECTOR
504 KAE COURT
MOLALLA OR 97038

Officer/Director/Trustee Five

NICK SORENSON
DIRECTOR
38484 S HARDY RD
MOLALLA OR 97038

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/6/2017
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N11 - Single Organization Support
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 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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