FORM 1023-EZ for FLORA ID

Field Data
EIN 81-4866582
Case Number EO-2017011-000328
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FLORA ID
Organization’s Mailing Address 731 NW 5TH ST
City PENDLETON
State OR
ZIP 97801-1307
Accounting period End 12
Primary contact name BRUCE S BARNES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JERRY BAKER
CHAIR, CHIEF EXECUTIVE OFFICER
410 N 4TH ST
ATHENA OR 97813

Officer/Director/Trustee Two

CHERYL SHIPPENTOWER
TREASURER
PO BOX 1042
PENDLETON OR 97801

Officer/Director/Trustee Three

KIT MORGAN
SECRETARY
801 NW 8TH
PENDLETON OR 97801

Officer/Director/Trustee Four

DON MANSFIELD
DIRECTOR
3204 N HAWTHORNE DR
BOISE ID 83703

Officer/Director/Trustee Five

MARK DARRACH
DIRECTOR
20762 HEMLOCK ST NE
INDIANOLA WA 98342

Organization’s website
Organization’s email FLORA.ID@WTECHLINK.US
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/3/2017
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C41 - Botanical Gardens, Arboreta and Botanical Organizations
Organization’s purpose Charitable: Yes
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 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
Signature Title
Signature Date

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