FORM 1023-EZ for COWLITZ OFF LEASH ASSOCATION

Field Data
EIN 83-1154750
Case Number EO-2018192-000224
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COWLITZ OFF LEASH ASSOCATION
Organization’s Mailing Address 1105 15TH AVENUE SUITE D508
City LONGVIEW
State WA
ZIP 98632
Accounting period End 12
Primary contact name DAVID CRANE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID CRANE
PRESIDENT
1105 15TH AVENUE SUITE D508
LONGVIEW WA 98632

Officer/Director/Trustee Two

TONY ENGEBRETSON
VICE PRESIDENT
2848 LARCH STREET
LONGVIEW WA 98632

Officer/Director/Trustee Three

MARY PETERSON
SECRETARY
2702 MAPLE STREET
LONGVIEW WA 98632

Officer/Director/Trustee Four

JUDY HIMEBAUGH
TREASURER
2911 SOUTH 3RD STREET
KELSO WA 98626

Officer/Director/Trustee Five

EDDIE ROGERSON
BOARD MEMBER
2275 34TH AVENUE
LONGVIEW WA 98632

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/12/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D12 - Fund Raising and/or Fund Distribution
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DAVID CRANE
Signature Title PRESIDENT
Signature Date 7/9/18

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