FORM 1023-EZ for MT HOOD YOUTH FOOTBALL ASSOCIATION

Field Data
EIN 84-4772400
Case Number EO-2020055-000854
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MT HOOD YOUTH FOOTBALL ASSOCIATION
Organization’s Mailing Address 4233 SE 182ND AVE PMB 323
City GRESHAM
State OR
ZIP 97080
Accounting period End 12
Primary contact name DENISE SELF
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DENISE SELF
PRESIDENT
2704 SW WILLOW PARKWAY
GRESHAM OR 97080

Officer/Director/Trustee Two

JESUS ORTIZ
TREASURER / DIRECTOR
2600 NE 205TH AVE 10
FAIRVIEW OR 97024

Officer/Director/Trustee Three

SUZIE ALBIN
SECRETARY / DIRECTOR
12744 SE MILL ST
PORTLAND OR 97233

Officer/Director/Trustee Four

LES CHAMBERLAIN
VICE PRESIDENT / DIRECTOR
17221 SCALES AVE
SANDY OR 97055

Officer/Director/Trustee Five

CHARLES SELF JR
DIRECTOR
2704 SW WILLOW PARKWAY
GRESHAM OR 97080

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/18/2020
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N65 - Football Clubs, Leagues
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 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 DENISE SELF
Signature Title PRESIDENT
Signature Date 2/22/2020

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