FORM 1023-EZ for OPEN MIND MISSION

Field Data
EIN 38-4093824
Case Number EO-2018302-000571
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name OPEN MIND MISSION
Organization’s Mailing Address 3260 NW IVY LN
City CAMAS
State WA
ZIP 98607
Accounting period End 12
Primary contact name VIKTOR CHEPELYUK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VIKTOR CHEPELYUK
DIRECTOR
3260 NW IVY LN
CAMAS WA 98607

Officer/Director/Trustee Two

ELLINA KECHIK
DIRECTOR
773 NW 13TH ST
GRESHAM OR 97030

Officer/Director/Trustee Three

IRINA CHEPELYUK
OFFICER
3260 NW IVY LN
CAMAS WA 98607

Organization’s website
Organization’s email IVTREO@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/22/16
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 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 VIKTOR CHEPELYUK
Signature Title DIRECTOR
Signature Date 10/26/18

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