FORM 1023-EZ for UC-VEG

Field Data
EIN 81-3556441
Case Number EO-2017173-000250
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UC-VEG
Organization’s Mailing Address PO BOX 89
City UMPQUA
State OR
ZIP 97486
Accounting period End 12
Primary contact name DAVID E ATKIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN DIMOF
PRESIDENT
214 NICHOLAS CT
SUTHERLIN OR 97479

Officer/Director/Trustee Two

JILL ALANE HANSON
SECRETARY
1620 FISHER ROAD
ROSEBURG OR 97471

Officer/Director/Trustee Three

RAMONA JANE SCHULZE
DIRECTOR
839 SPARKS ROAD
OAKLAND OR 97462

Officer/Director/Trustee Four

PATRICK WARREN HARRIS
DIRECTOR
226 NE PLUM RIDGE DRIVE
WINSTON OR 97496

Officer/Director/Trustee Five

JULIETE PALENSHUS
DIRECTOR
458 W UMPQUA ST
ROSEBURG OR 97471

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/14/2016
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K99 - Food, Agriculture, and Nutrition N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
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 Yes
One Third Support Gifts No
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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