FORM 1023-EZ for TRI-VILLAGE ALLIANCE

Field Data
EIN 84-3620776
Case Number EO-2019316-000184
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TRI-VILLAGE ALLIANCE
Organization’s Mailing Address PO BOX 332
City KING SALMON
State AK
ZIP 99613
Accounting period End 12
Primary contact name JAN BO STAHL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK STURM
PRESIDENT
PO BOX 332
KING SALMON AK 99613

Officer/Director/Trustee Two

SHANNON HARVILLA
VICE PRESIDENT
PO BOX 83
NAKNEK AK 99613

Officer/Director/Trustee Three

AMANDA WLAYSEWSKI
TREASURER/SECRETARY
PO BOX 83
KING SALMON AK 99613

Organization’s website
Organization’s email TRIVILLAGE-ALLIANCE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/6/19
Organization Incorporation State AK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 MARK STURM
Signature Title PRESIDENT
Signature Date 11/7/19

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