FORM 1023-EZ for FLORENCE EMERGENCY COLD WEATHER SHELTER COMMITTEE

Field Data
EIN 47-2168304
Case Number EO-2015153-000066
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FLORENCE EMERGENCY COLD WEATHER SHELTER COMMITTEE
Organization’s Mailing Address PO BOX 55
City FLORENCE
State OR
ZIP 97439-0002
Accounting period End 12
Primary contact name ROBERT DUBOSE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT DUBOSE
COMMITTEE CHAIRPERSON
PO BOX 55
FLORENCE OR 97439-0002

Officer/Director/Trustee Two

PAUL HIRSCH
TREASURE
PO BOX 55
FLORENCE OR 97439-0002

Officer/Director/Trustee Three

JUDITH PREISLER
SECRETARY
PO BOX 55
FLORENCE OR 97439-0002

Organization’s website WWW.COLDSHELTER.ORG
Organization’s email DUBOSERW@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/28/2014
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L41 - Homeless, Temporary Shelter For
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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