FORM 1023-EZ for DOUGLAS COMMUNITY LIBRARY ASSOCIATION

Field Data
EIN 82-3129813
Case Number EO-2017313-000131
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DOUGLAS COMMUNITY LIBRARY ASSOCIATION
Organization’s Mailing Address PO BOX 4790
City SUTHERLIN
State OR
ZIP 97527
Accounting period End 12
Primary contact name DAVID E ATKIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GARY WAUGAMAN
PRESIDENT
9496 SOUTH BANK DR
ROSEBURG OR 97470

Officer/Director/Trustee Two

RICK TROXEL
VICE PRESIDENT
2086 CULVER LOOP
SUTHERLIN OR 97479

Officer/Director/Trustee Three

DORIS BARTLETT
SECRETARY
PO BOX 340
YONCALLA OR 97499

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/14/2017
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B02 - Management & Technical Assistance
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 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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