FORM 1023-EZ for PRINEVILLE LIONS FOUNDATION

Field Data
EIN 82-5524990
Case Number EO-2018141-000685
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PRINEVILLE LIONS FOUNDATION
Organization’s Mailing Address 6282 S CROOKED RIVER HWY
City PRINEVILLE
State OR
ZIP 97754
Accounting period End 6
Primary contact name WILLIAM BRITT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICHARD HOLLENBECK
PRESIDENT
8280 NW LAMONTA RD
PRINEVILLE OR 97754

Officer/Director/Trustee Two

MELANIE MARLOW
VICE PRESIDENT
PO BOX 371
PRINEVILLE OR 97754

Officer/Director/Trustee Three

BARB BAYLESS
SECRETARY
1043 NE MOUNTAIN ASH RD
PRINEVILLE OR 97754

Officer/Director/Trustee Four

STACY BERNARD
TREASURER
759 SE KNOWLEDGE STREET
PRINEVILLE OR 97754

Officer/Director/Trustee Five

WILLIAM BRITT
DIRECTOR
6282 S CROOKED RIVER HWY
PRINEVILLE OR 97754

Organization’s website
Organization’s email RIMROCK2020@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/4/18
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
Organization’s purpose Charitable: Yes
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 WILLIAM BRITT
Signature Title DIRECTOR
Signature Date 5/19/18

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