FORM 1023-EZ for HEALTHY COMMUNITY COLLECTIVE

Field Data
EIN 85-0898965
Case Number EO-2020126-000074
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALTHY COMMUNITY COLLECTIVE
Organization’s Mailing Address 809 CASCADE AVE
City HOOD RIVER
State OR
ZIP 97031
Accounting period End 12
Primary contact name PAUL LINDBERG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAUL LINDBERG
PRESIDENT
809 CASCADE AVE
HOOD RIVER OR 97031

Officer/Director/Trustee Two

PEG BOGARD
BOARD MEMBER
654 HUNTER ROAD
HOOD RIVER OR 97031

Officer/Director/Trustee Three

CHLOE HIGHT
BOARD MEMBER
2418 NE OREGON ST
PORTLAND OR 97232

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/1/2020
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P19 - Nonmonetary Support N.E.C.
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 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 PAUL LINDBERG
Signature Title PRESIDENT
Signature Date 5/1/2020

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