FORM 1023-EZ for MOUNTAINSIDE JBO

Field Data
EIN 82-1537229
Case Number EO-2017142-000455
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOUNTAINSIDE JBO
Organization’s Mailing Address 16345 SW CINNABAR CT
City BEAVERTON
State OR
ZIP 97007
Accounting period End 10
Primary contact name BRIAN KRUHM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRIAN KRUHM
VP
16345 CINNABAR CT
BEAVERTON OR 97007

Officer/Director/Trustee Two

JONATHAN MANN
TREASURER
10160 SW EGRET PL
BEAVERTON OR 97007

Officer/Director/Trustee Three

BRIAN WHEELER
PRESIDENT
14780 SW OSPREY DR
BEAVERTON OR 97007

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/18/2017
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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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