FORM 1023-EZ for UMPQUA VALLEY BMX

Field Data
EIN 82-2164175
Case Number EO-2017207-000085
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UMPQUA VALLEY BMX
Organization’s Mailing Address 103 WENAHA LN
City ROSEBURG
State OR
ZIP 97471
Accounting period End 12
Primary contact name MIKE CUMMINGS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRISSY SORENSAN
PRESIDENT
103 WENAHA LN
ROSEBURG OR 97471

Officer/Director/Trustee Two

AMANDA QUINN
SECRETARY/TREASURER
103 WENAHA LN
ROSEBURG OR 97471

Officer/Director/Trustee Three

JUDY REAGAN
DIRECTOR
103 WENAHA LN
ROSEBURG OR 97471

Officer/Director/Trustee Four

DALLEN SORENSEN
DIRECTOR
103 WENAHA LN
ROSEBURG OR 97471

Officer/Director/Trustee Five

MIKE CUMMINGS
DIRECTOR
103 WENAHA LN
ROSEBURG OR 97471

Organization’s website
Organization’s email UMPQUAVALLEYBMX@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/29/2017
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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
Signature Title
Signature Date

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