FORM 1023-EZ for LOCAL OPPORTUNITIES TO IMPROVE SURVIVAL

Field Data
EIN 47-4456641
Case Number EO-2015294-000112
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LOCAL OPPORTUNITIES TO IMPROVE SURVIVAL
Organization’s Mailing Address 4829 SE 71ST STREET
City PORTLAND
State OR
ZIP 97206
Accounting period End 12
Primary contact name TANJA ENGLBERGER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TANJA ENGLBERGER
DIRECTOR
2040 ANTANANARIVO PL APT 6
DULLES VA 20189

Officer/Director/Trustee Two

ERIN FORSTAG
REGISTERED AGENT
4829 SE 71ST AVE
PORTLAND OR 97206

Officer/Director/Trustee Three

KATY SUELLENTROP
SECRETARY OF BOARD
5920 5TH ST N ARLINGTON
ARLINGTON VA 22203

Organization’s website HTTP://LOISNGO.ORG/
Organization’s email CONTACTLOISNGO@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/6/2015
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
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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