FORM 1023-EZ for WILLAMETTE VALLEY CLEAN WATER ALLIANCE

Field Data
EIN 46-3906976
Case Number EO-2014338-000163
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WILLAMETTE VALLEY CLEAN WATER ALLIANCE
Organization’s Mailing Address 780 BAILEY HILL ROAD SUITE 5
City EUGENE
State OR
ZIP 97402
Accounting period End 12
Primary contact name DAVID ATKIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TIMOTHY HOVET
PRESIDENT
2454 NORTH 17TH STREET
SPRINGFIELD OR 97477

Officer/Director/Trustee Two

RALPH PERKINS
VICE PRESIDENT
37634 WALLACE CREEK ROAD
SPRINGFIELD OR 97478

Officer/Director/Trustee Three

PAUL REED
SECRETARY
84848 LORANE HIGHWAY
EUGENE OR 97405

Officer/Director/Trustee Four

WALTER BORNTRAGER
DIRECTOR
1300 NORTH RIVER ROAD
COTTAGE GROVE OR 97424

Officer/Director/Trustee Five

DAVID ATKIN
DIRECTOR
590 WEST 13TH AVENUE
EUGENE OR 97402

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/21/2013
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C30 - Natural Resources Conservation and Protection
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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