FORM 1023-EZ for PUYALLUP VALLEY GEM AND MINERAL CLUB

Field Data
EIN 91-6057702
Case Number EO-2016286-000177
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PUYALLUP VALLEY GEM AND MINERAL CLUB
Organization’s Mailing Address 4108 61ST ST E
City TACOMA
State WA
ZIP 98443
Accounting period End 12
Primary contact name LARRY HOFFMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JIM CHRISTIAN
PRESIDENT
13814 109TH AVE CT E
PUYALLUP WA 98374

Officer/Director/Trustee Two

GLEN RIPPER
VICE PRESIDENT
21102 91ST ST E
BONNEY LAKE WA 98390

Officer/Director/Trustee Three

KARNE LEBETER
SECRETARY
15106 WOODBROOK DR SW
LAKEWOOD WA 98439

Officer/Director/Trustee Four

LARRY HOFFMAN
TREASURER
4108 61ST ST E
TACOMA WA 98443

Officer/Director/Trustee Five

JOHN HUBER
FEDERATION DIRECTOR
11012 INTERLAAKEN DR SW
LAKEWOOD WA 98498

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/28/1994
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code U36 - Geology
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: Yes
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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