FORM 1023-EZ for BULLDOG MAT CLUB

Field Data
EIN 81-5037760
Case Number EO-2017025-000095
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BULLDOG MAT CLUB
Organization’s Mailing Address 21919 SW WILLAMINA CREEK ROAD
City WILLAMINA
State OR
ZIP 97396
Accounting period End 12
Primary contact name ANGELA FASANA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RAY CARPENTER
PRESIDENT
1322 SW PIONEER DRIVE
WILLAMINA OR 97396

Officer/Director/Trustee Two

STACIE CARPENTER
TREASURER
420 SE EXCELL STREET
SHERIDAN OR 97378

Officer/Director/Trustee Three

ANGELA FASANA
DIRECTOR
21919 SW WILLAMINA CREEK ROAD
WILLAMINA OR 97396

Organization’s website
Organization’s email BULLDOGMATCLUB@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/28/2016
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
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 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 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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