FORM 1023-EZ for OREGON UROLOGICAL SOCIETY
| Field | Data |
|---|---|
| EIN | 93-6069981 |
| Case Number | EO-2016125-000259 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | OREGON UROLOGICAL SOCIETY |
| Organization’s Mailing Address | 1819 SW 5TH AVE 268 |
| City | PORTLAND |
| State | OR |
| ZIP | 97201 |
| Accounting period End | 12 |
| Primary contact name | MARILYN KRITZER CPA |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
Officer/Director/Trustee One
BRIAN SHAFFER MD
PRESIDENT
9135 SW BARNES RD 663
PORTLAND OR 97225
Officer/Director/Trustee Two
STANLEY MYERS MD
IMMEDIATE PAST PRESIDENT
2230 NW PETTYGROVE 210
PORTLAND OR 97210
Officer/Director/Trustee Three
JACK LEWIS MD
PRESIDENT ELECT
1698 E MCANDREWS 280
MEDFORD OR 98504
Officer/Director/Trustee Four
PAT DAVOL MD
SECRETARY TREASURER
1736 NE SHALE CT
ROSEBURG OR 97470
Officer/Director/Trustee Five
DEBORAH JOHNSON
EXECUTIVE DIRECTOR
914 164TH ST SE 310
MILL CREEK WA 98012
| Organization’s website | WWW.OREGONUROLOGICALSOCIETY.ORG |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 4/20/2012 |
| Organization Incorporation State | OR |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E03 - Professional Societies, Associations |
| 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 | 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 | |
| Signature Title | |
| Signature Date |
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