FORM 1023-EZ for KLAMATH BASIN PICKLEBALL ASSOCIATION INC

Field Data
EIN 82-5485032
Case Number EO-2018207-000168
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KLAMATH BASIN PICKLEBALL ASSOCIATION INC
Organization’s Mailing Address PO BOX 6
City KLAMATH FALLS
State OR
ZIP 97601
Accounting period End 4
Primary contact name TOM ROMIG CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KRISTI REDD
PRESIDENT
5710 NORTH HILLS DR
KLAMATH FALLS OR 97603

Officer/Director/Trustee Two

FREDERICK ZWARTVERWER MD
VICE PRESIDENT
12179 MERGANSER RD
KLAMATH FALLS OR 97601

Officer/Director/Trustee Three

KAREN HARPER
TREASURER
2220 ROUND LAKE RD
KLAMATH FALLS OR 97601

Officer/Director/Trustee Four

NANCY PRATT
SECRETARY
3834 BEVERLY DR
KLAMATH FALLS OR 97603

Officer/Director/Trustee Five

YOLANDA BUCHANAN
MEMBER-AT-LARGE
2518 HAWKINS
KLAMATH FALLS OR 97601

Organization’s website WWW.KBPICKLEBALL.COM
Organization’s email KBPICKLEBALL@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/8/18
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N66 - Tennis, Racquet Sports Clubs, Leagues
Organization’s purpose Charitable: No
Religious: No
Educational: No
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 KRISTI REDD
Signature Title PRESIDENT
Signature Date 7/24/18

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