FORM 1023-EZ for LANE K BROWN FOUNDATION

Field Data
EIN 83-1889216
Case Number EO-2019144-000151
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LANE K BROWN FOUNDATION
Organization’s Mailing Address PO BOX 1626
City PULLMAN
State WA
ZIP 99163
Accounting period End 12
Primary contact name AUTUMN AVERY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHANE BROWN
PRESIDENT
605 NW FISK ST TRLR 39
PULLMAN WA 99163

Officer/Director/Trustee Two

PATRICK MARKWELL
VIE PRESIDENT
402 N 3RD STREET
GARFILED WA 99130

Officer/Director/Trustee Three

AUTUMN AVERY
TREASURER
755 NW FISK STREET
PULLMAN WA 99163

Officer/Director/Trustee Four

RAY HAZELTINE
SECRETARY
605 NW FISK S TRLR 63
PULLMAN WA 99163

Officer/Director/Trustee Five

STARLING LINDSEY
PUBLIC RELATIONS
107 G STREET
ALBION WA 99102

Organization’s website WWW.LANEKBROWNFOUNDATION.ORG
Organization’s email TREASURER@LANEKBROWNFOUNDATION.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/11/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
Disaster relief assistance Yes
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 AUTUMN AVERY
Signature Title TREASURER
Signature Date 5/22/19

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