FORM 1023-EZ for KEIKIS

Field Data
EIN 82-3779978
Case Number EO-2018043-000290
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KEIKIS
Organization’s Mailing Address 1692 NW JACIE WAY
City MCMINNVILLE
State OR
ZIP 97128
Accounting period End 12
Primary contact name REID KIMURA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

REID KIMURA
PRESIDENT
1692 NW JACIE WAY
MCMINNVILLE OR 97128

Officer/Director/Trustee Two

POLLY DUNKLEY
VICE CHAIR
1610 SNAPDRAGON LANE
FOREST GROVE OR 97116

Officer/Director/Trustee Three

KATRINA AMSBERRY
SECRETARY
1870 SW ACORN CT
MCMINNVILLE OR 97128

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/18/17
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: Yes
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 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 REID KIMURA
Signature Title PRESIDENT
Signature Date 2/8/18

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