FORM 1023-EZ for PAINTED HILLS WATER ASSOCIATION

Field Data
EIN 91-0996631
Case Number EO-2015260-000438
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PAINTED HILLS WATER ASSOCIATION
Organization’s Mailing Address PO BOX 704
City EPHRATA
State WA
ZIP 98823
Accounting period End 12
Primary contact name COLLEEN ALLRED
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TERRY BALTHAZOR
PRESIDENT
5304 PAINTED HILLS DR
EPHRATA WA 98823

Officer/Director/Trustee Two

SHANE AHMANN
VICE-PRESIDENT
5256 PAINTED HILLS DR
EPHRATA VT 98823

Officer/Director/Trustee Three

KEITH NIEHENKE
SECRETARY
5352 PAINTED HILLS DR
EPHRATA VI 98823

Officer/Director/Trustee Four

BILL GRAY
WATER BOARD CHAIRMAN
5115 PAINTED HILLS DR
EPHRATA WA 98823

Officer/Director/Trustee Five

COLLEEN ALLRED
TREASURER
5023 PAINTED HILLS DR
EPHRATA VT 98823

Organization’s website NONE
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/1975
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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