FORM 1023-EZ for O2WA SCHOLARSHIP FUND

Field Data
EIN 81-0692824
Case Number EO-2016351-000209
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name O2WA SCHOLARSHIP FUND
Organization’s Mailing Address 70 SW CENTURY DRIVE PMB 353
City BEND
State OR
ZIP 97702
Accounting period End 6
Primary contact name DAVID ATKIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRANNON LAMP
TREASURER
3439 NE SANDY BLVD - NO 165
PORTLAND OR 97232

Officer/Director/Trustee Two

ERIN MICK
PRESIDENT
1903 NE WEIDLER - NO 3
PORTLAND OR 97232

Officer/Director/Trustee Three

CHRIS RHODABACK
SECRETARY
PO BOX 444
ALBANY OR 97322

Officer/Director/Trustee Four

AARON DENNIS
DIRECTOR
150 BEAVERCREEK RD - SUITE 430
OREGON CITY OR 97045

Officer/Director/Trustee Five

DOUG DILLEY
VICE-PRESIDENT
33312 IDYLWILD RD - PO BOX 630
CRESWELL OR 97426

Organization’s website WWW.O2WA.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/5/2015
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
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 Yes
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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