FORM 1023-EZ for KLAMATH-LAKE INTERGROUP INC

Field Data
EIN 93-1316287
Case Number EO-2017172-000208
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KLAMATH-LAKE INTERGROUP INC
Organization’s Mailing Address 707 HIGH ST
City KLAMATH FALLS
State OR
ZIP 97601-2923
Accounting period End 12
Primary contact name RICHARD FOWLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TERRY K NASH
CHAIRPERSON
2509 HAWKINS ST
KLAMATH FALLS OR 97601-1240

Officer/Director/Trustee Two

SCOTT STEVENSON
VICE-CHAIRPERSON
10430 FINCH CT
KLAMATH FALLS OR 97601-9182

Officer/Director/Trustee Three

JUDY C THOMAS
SECRETARY
44341 COWBOY HILL
CHILOQUIN OR 97624-5843

Officer/Director/Trustee Four

SUZAN MOLYNEUX
TREASURER
1405 OLD FORT RD
KLAMATH FALLS OR 97601-9431

Officer/Director/Trustee Five

RICHARD FOWLER
OFFICE MANAGER
33219 MOUNTAIN LAKES DR
KLAMATH FALLS OR 87601-8508

Organization’s website KLCIAA.ORG
Organization’s email KLCINTERGROUP@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/2001
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F21 - Alcohol, Drug Abuse, Prevention Only
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 Yes
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 Yes
One Third Support Gifts No
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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