FORM 1023-EZ for MCTD FOUNDATION

Field Data
EIN 81-2333671
Case Number EO-2016118-000148
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MCTD FOUNDATION
Organization’s Mailing Address 1900 NE 3RD STREET 106-316
City BEND
State OR
ZIP 97701-3979
Accounting period End 12
Primary contact name KERRY LILIEDAHL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ERIN DUFFY
PRESIDENT
17963 BEARDSLEY STREET
CASTRO VALLEY CA 94546

Officer/Director/Trustee Two

DARILYN RICE
SECRETARY
3333 WHITE BIRCH PLACE
THOUSAND OAKS OR 91360

Officer/Director/Trustee Three

KERRY LILIEDAHL
TREASURER
1900 NE 3RD STREET 106-316
BEND

Officer/Director/Trustee Four

CHRISTIE DUFFY
BOARD OF DIRECTORS
17963 BEARSLEY STREET
CASTRO VALLEY CA 94546

Officer/Director/Trustee Five

DEBBIE NEWTON
BOARD OF DIRECTORS
36 MOUNTAIN SHADOWS PLACE
PHILLIPS RANCH CA 91766

Organization’s website WWW.MCTDFOUNDATION.ORG
Organization’s email MCTDFOUNDATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/29/2016
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G80 - Specifically Named Diseases
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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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