FORM 1023-EZ for PRINEVILLE RE-USE STORE

Field Data
EIN 81-2662621
Case Number EO-2016172-000227
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PRINEVILLE RE-USE STORE
Organization’s Mailing Address 1427 NW MURPHY CT
City PRINEVILLE
State OR
ZIP 97754
Accounting period End 12
Primary contact name DON VANBUSKIRK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DONALD VANBUSKIRK
CHAIR
7143 SE IOWA RD
PRINEVILLE OR 97754

Officer/Director/Trustee Two

REBECA FRISBEE
TREASURER
540 NW 2ND ST
PRINEVILLE OR 97754

Officer/Director/Trustee Three

KATIE RHODES
SECRETARY
904 B NE 2ND ST
PRINEVILLE OR 97754

Officer/Director/Trustee Four

DARYL OWENS
DIRECTOR
6705 SE DAVIS LOOP
PRINEVILLE OR 97754

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/18/2016
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L12 - Fund Raising and/or Fund Distribution
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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