FORM 1023-EZ for PRINEVILLE CANCER PRAYER BAGS

Field Data
EIN 84-3387097
Case Number EO-2019331-000284
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PRINEVILLE CANCER PRAYER BAGS
Organization’s Mailing Address PO BOX 1453
City PRINEVILLE
State OR
ZIP 97754
Accounting period End 12
Primary contact name CINDY DAVENPORT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEBRA HICKS
PRESIDENT
1310 NW DODSON
PRINEVILLE OR 97754

Officer/Director/Trustee Two

CINDY DAVENPORT
DIRECTOR/TREASURER / SECRETARY
2232 NE CHERRY LOOP
PRINEVILLE OR 97754

Officer/Director/Trustee Three

MABEL GRAY
VP / CHAIRPERSON
1273 S MAIN STREET
PRINEVILLE OR 97754

Organization’s website FACEBOOK.COM/CROOKCOUNTYOREGON/PRINEVILLECANCERPRAYERBAGS
Organization’s email PCANCERPB@OUTLOOK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/16/19
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G30 - Cancer
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 CINDY DAVENPORT
Signature Title DIRECTOR/TREASURER / SECRETARY
Signature Date 11/25/19

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