FORM 1023-EZ for LEVIS LEGACY DIPG FOUNDATION

Field Data
EIN 61-1988171
Case Number EO-2021131-000137
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LEVIS LEGACY DIPG FOUNDATION
Organization’s Mailing Address 915 NW 4TH STREET
City GRESHAM
State OR
ZIP 97030-6915
Accounting period End 12
Primary contact name TYLER SMITH AND ASSOCIATES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENICA CASTILLO-HAR
PRESIDENT
915 NW 4TH STREET
GRESHAM OR 97030-6915

Officer/Director/Trustee Two

NICK CASTILLO
TREASURER
915 NW 4TH STREET
GRESHAM OR 97030-6915

Officer/Director/Trustee Three

NATHAN HARDEN
SECRETARY
915 NW 4TH STREET
GRESHAM OR 97030-6915

Officer/Director/Trustee Four

GREG MOON
VICE PRESIDENT
3379 SE TEAL DRIVE
GRESHAM OR 97080-8090

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/6/2021
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 JENICA CASTILLO-HAR
Signature Title PRESIDENT
Signature Date 5/7/2021

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