FORM 1023-EZ for ROGUE HERBALISM

Field Data
EIN 83-3862248
Case Number EO-2019200-000374
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROGUE HERBALISM
Organization’s Mailing Address 109 CLEAR CREEK DRIVE SUITE 101
City ASHLAND
State OR
ZIP 97520
Accounting period End 12
Primary contact name PARIS CONWELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PEARL SITES
PRESIDENT
109 CLEAR CREEK DRIVE SUITE 101
ASHLAND OR 97520

Officer/Director/Trustee Two

LISA HENDRICK
VICE PRESIDENT
109 CLEAR CREEK DRIVE SUITE 101
ASHLAND OR 97520

Officer/Director/Trustee Three

PARIS CONWELL
SECRETARY-TREASURER
109 CLEAR CREEK DRIVE SUITE 101
ASHLAND OR 97520

Organization’s website WWW.ROGUEHERBALISM.COM
Organization’s email INFO@ROGUEHERBALISM.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/7/19
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E01 - Alliance/Advocacy Organizations
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 PARIS CONWELL
Signature Title SECRETARY-TREASURER
Signature Date 7/17/19

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