FORM 1023-EZ for UMPQUA VALLEY CHILDBIRTH EDUCATION

Field Data
EIN 46-1861209
Case Number EO-2015061-000261
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UMPQUA VALLEY CHILDBIRTH EDUCATION
Organization’s Mailing Address 1426
City ROSEBURG
State OR
ZIP 97470
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

ANDRIA WINTERS
PRESIDENT
5 NE SPYGLASS LOOP
ROSEBURG OR 97470

Officer/Director/Trustee Two

ELIZABETH MIGNOLA
SECRETARY/TREASURER
338 OAKVIEW DRIVE
ROSEBURG OR 97470

Officer/Director/Trustee Three

LINDA MIDDLEKAUFF
DIRECTOR
1426
ROSEBURG OR 97470

Officer/Director/Trustee Four

CATHERINE PAUL
DIRECTOR
166 W BODIE STREET
ROSEBURG OR 97471

Officer/Director/Trustee Five

LISA SULFFRIDGE
DIRECTOR
331
GLIDE OR 97443

Organization’s website
Organization’s email 2GWM6LJM9@CHARTER.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/27/2012
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
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 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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