FORM 1023-EZ for MOUNTAINSIDE YOUTH BASKETBALL INC

Field Data
EIN 82-2597429
Case Number EO-2017240-000451
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOUNTAINSIDE YOUTH BASKETBALL INC
Organization’s Mailing Address 16399 SW HOOPS CT
City TIGARD
State OR
ZIP 97223
Accounting period End 5
Primary contact name WENDY JORDAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MATTHEW GEHRKE
PRESIDENT
7670 SW BARNARD DR
BEAVERTON OR 97007

Officer/Director/Trustee Two

BRANDON HAGEMAN
VICE-PRESIDENT
11175 SW PARTRIDGE LOOP
BEAVERTON OR 97007

Officer/Director/Trustee Three

WENDY JORDAN
TREASURER
12356 SW CANVASBACK WAY
BEAVERTON OR 97007

Officer/Director/Trustee Four

JOHN WEATHERS
SECRETARY
16399 SW HOOPS CT
TIGARD OR 97223

Officer/Director/Trustee Five

CYNTHIA NEELY
UNIFORM COORDINATOR
6944 SW TIERRA DEL MAR DR
BEAVERTON OR 97007

Organization’s website
Organization’s email WENDYANDJAY07@MSN.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/23/2017
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N62 - Basketball
Organization’s purpose Charitable: No
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
Signature Title
Signature Date

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