FORM 1023-EZ for NORTH SANTIAM YOUTH ATHLETICS

Field Data
EIN 83-2361448
Case Number EO-2019031-001041
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NORTH SANTIAM YOUTH ATHLETICS
Organization’s Mailing Address PO BOX 441
City STAYTON
State OR
ZIP 97383
Accounting period End 6
Primary contact name RON GOWER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RON GOWER
PRESIDENT
220 DOVE ST SE
SUBLIMITY OR 97385

Officer/Director/Trustee Two

NANCY MORRIS
DIRECTOR
875 N 5TH
AUMSVILLE OR 97325

Officer/Director/Trustee Three

DEVIN HLAVINKA
DIRECTOR
120 N EVERGREEN
STAYTON OR 97383

Officer/Director/Trustee Four

RYAN MORRIS
TREASURER
875 N 5TH
AUMSVILLE OR 97325

Officer/Director/Trustee Five

BOB ANDERSON
SECRETARY
2155 SPRING BREEZE DR
STAYTON OR 97383

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/29/18
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
Organization’s purpose Charitable: No
Religious: No
Educational: No
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 RON GOWER
Signature Title PRESIDENT
Signature Date 1/8/19

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