FORM 1023-EZ for DEWEY SULLIVAN MEMORIAL FOUNDATIONINC

Field Data
EIN 46-1873557
Case Number EO-2014363-000113
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DEWEY SULLIVAN MEMORIAL FOUNDATIONINC
Organization’s Mailing Address 3265 LIBERTY RD S
City SALEM
State OR
ZIP 97302
Accounting period End 12
Primary contact name WALLACE W LIEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

WILLIAM STOLLER
PRESIDENT
15505 NE STOLLER ROAD
DAYTON OR 97114

Officer/Director/Trustee Two

SHAWN SUTTON
SECRETARY
BOX 6
DAYTON OR 97114-0006

Officer/Director/Trustee Three

KIM COURTIN
TREASURER
525 FERRY STREET
DAYTON OR 97114

Officer/Director/Trustee Four

VERA SULLIVAN
BOARD MEMBER
16501 SE WOODLAND HEIGHTS RD
AMITY OR 97101-2138

Officer/Director/Trustee Five

WALLACE LIEN
ATTORNEY FOR FOUNDATION
3265 LIBERTY ROAD S
SALEM OR 97302

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/25/2013
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O12 - 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 Yes
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
Signature Title
Signature Date

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