FORM 1023-EZ for RFAN

Field Data
EIN 46-4522375
Case Number EO-2014300-000441
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RFAN
Organization’s Mailing Address 12636 175TH AVE SW
City ROCHESTER
State WA
ZIP 98579
Accounting period End 12
Primary contact name LOWELL DEGUISE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARK FAGERNES
DIRECTOR
12636 175TH AVE SW
ROCHESTER WA 98579

Officer/Director/Trustee Two

BRIAN FAGERNES
DIRECTOR
9111 178TH AVE SW
ROCHESTER WA 98579

Officer/Director/Trustee Three

TODD FAGERNES
DIRECTOR
12337 170TH AVE SW
ROCHESTER WA 98579

Officer/Director/Trustee Four

LARRY AYERS
DIRECTOR
11509 INDEPENDENCE RD SW
ROCHESTER WA 98579

Officer/Director/Trustee Five

LOWELL DEGUISE
DIRECTOR
PO BOX 392
ROCHESTER WA 98579

Organization’s website WWW.ROCHESTERFAN.COM
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/14/2014
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P60 - Emergency Assistance (Food, Clothing, Cash)
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 Yes
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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