FORM 1023-EZ for KLAMATH FALLS GUN CLUB

Field Data
EIN 84-2548303
Case Number EO-2019221-000100
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KLAMATH FALLS GUN CLUB
Organization’s Mailing Address PO BOX 1011
City KLAMATH FALLS
State OR
ZIP 97601
Accounting period End 6
Primary contact name JERED REID
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOE SAMMIS
DIRECTOR; PRESIDENT
PO BOX 625
DORRIS CA 96023

Officer/Director/Trustee Two

RICHARD SIEMENS
DIRECTOR; VICE PRESIDENT
39146 HIGHWAY 62
CHILOQUIN OR 97624

Officer/Director/Trustee Three

ALLAN BROWN
DIRECTOR; SECRETARY/TREASURER
451 DONALD STREET
KLAMATH FALLS OR 97601

Officer/Director/Trustee Four

VELMA THIEL
DIRECTOR
PO BOX 293
KENO OR 97627

Officer/Director/Trustee Five

LISA JOHNSON
DIRECTOR
4620 DENVER AVENUE
KLAMATH FALLS OR 97603

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/29/19
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 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 JOE SAMMIS
Signature Title DIRECTOR; PRESIDENT
Signature Date 8/7/19

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