FORM 1023-EZ for LLAMA CLUB

Field Data
EIN 84-3321879
Case Number EO-2019284-000711
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LLAMA CLUB
Organization’s Mailing Address 5109 SE 104TH AVE
City PORTLAND
State OR
ZIP 97266
Accounting period End 12
Primary contact name TABITHA DONAGHUE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TABITHA DONAGHUE
ORGANIZER
5109 SE 104TH AVE
PORTLAND OR 97266

Organization’s website WWW.LLAMACLUB.COM
Organization’s email LLAMACLUBPDX@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/31/18
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
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 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 TABITHA DONAGHUE
Signature Title ORGANIZER
Signature Date 10/9/19

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