FORM 1023-EZ for FOREST BREEZE CONSERVATION
| Field | Data |
|---|---|
| EIN | 86-1572289 |
| Case Number | EO-2021095-000456 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | FOREST BREEZE CONSERVATION |
| Organization’s Mailing Address | 28615 SW PARIS AVE UNIT 307 |
| City | WILSONVILLE |
| State | OR |
| ZIP | 97070 |
| Accounting period End | 12 |
| Primary contact name | DAVID E ATKIN |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
PATRICK FLORA
PRESIDENT
2982 SOSCOL AVE APT 102
NAPA CA 94558
Officer/Director/Trustee Two
TRACY MAHAFFEY
TREASURER
4139 SCHWINN DR
DAYTON OH 45404
Officer/Director/Trustee Three
RACHEL KLEIN
SECRETARY
400 SPRING ST APT 108
ST. PAUL MN 55102
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 12/17/2020 |
| Organization Incorporation State | OR |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | D30 - Wildlife Preservation, Protection |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes Scientific: Yes Literary: No Public Safety: No Amateur Sports: No Cruelty Prevention: Yes |
| Qualify For Exemption | No |
| Legislation influence | No |
| Compensation of Officer director trustee | No |
| Donation of funds | No |
| Conducting Activities Outside of United States | Yes |
| 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 | PATRICK FLORA |
| Signature Title | PRESIDENT |
| Signature Date | 3/8/2021 |
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