FORM 1023-EZ for ALLIANCE FOR NATIVE YOUTH SCHOLARSHIP
| Field | Data |
|---|---|
| EIN | 83-0901733 |
| Case Number | EO-2019035-000323 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | ALLIANCE FOR NATIVE YOUTH SCHOLARSHIP |
| Organization’s Mailing Address | 2160 SOUTH PACIFIC HWY |
| City | TALENT |
| State | OR |
| ZIP | 97540 |
| Accounting period End | 9 |
| Primary contact name | TESSA SCROGGIN-LAKE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
TESSA SCROGGIN-LAKE
FOUNDER
2160 S PACIFIC HWY
TALENT OR 97540
Officer/Director/Trustee Two
KRISTIN SIVESIND
DIRECTOR
1497 WINDSOR WAY
ASHLAND OR 97520
Officer/Director/Trustee Three
ADRIA THOMAS
MEDICAL OFFICER
2057 NE MASON
PORTLAND OR 97211
| Organization’s website | |
|---|---|
| Organization’s email | ALLIANCE4NATIVEYOUTH@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 9/14/18 |
| Organization Incorporation State | OR |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | A20 - Arts, Cultural Organizations - Multipurpose |
| Organization’s purpose | Charitable: Yes Religious: Yes 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 | No |
| Benefit of College | No |
| Private Foundation 508(e) | Yes |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | TESSA SCROGGIN-LAKE |
| Signature Title | FOUNDER |
| Signature Date | 1/9/19 |
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