FORM 1023-EZ for WILLAMETTE COIN CLUB

Field Data
EIN 82-3808438
Case Number EO-2018023-000352
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WILLAMETTE COIN CLUB
Organization’s Mailing Address PO BOX 19213
City PORTLAND
State OR
ZIP 97280-213
Accounting period End 12
Primary contact name TIM BISHOPRIC
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JIMMY KROZEL
PRESIDENT
2360 SW CHELMSFORD
PORTLAND OR 97201

Officer/Director/Trustee Two

DANIEL WELLS
VICE PRESIDENT
4479 SE BOARDMAN AVE
MILWAUKIE OR 97267

Officer/Director/Trustee Three

JASON BREEDLOVE
TREASURER
2318 NE MULTNOMAH ST / APT 3
PORTLAND OR 97232

Officer/Director/Trustee Four

TIMOTHY BISHOPRIC
SECRETARY
8121 SW 56TH AVE
PORTLAND OR 97219

Officer/Director/Trustee Five

LARRY GAYE
DIRECTOR
11695 SW WELCH TERRACE
BEAVERTON OR 97005-7911

Organization’s website HTTP://WWW.PDXCOINCLUB.COM/
Organization’s email PDXCOINCLUB@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/27/17
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
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 TIMOTHY BISHOPRIC
Signature Title SECRETARY
Signature Date 1/21/18

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