FORM 1023-EZ for INTERNATIONAL POLICE MUSEUM

Field Data
EIN 47-5022259
Case Number EO-2015295-000465
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name INTERNATIONAL POLICE MUSEUM
Organization’s Mailing Address 212 N HIGHWAY 101 PO BOX 165
City ROCKAWAY BEACH
State OR
ZIP 97136-0165
Accounting period End 12
Primary contact name EDWARD L WORTMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CECILE DOYLE
PRESIDENT
PO BOX 556
ROCKAWAY BEACH OR 97136-0556

Officer/Director/Trustee Two

HENRY BAUER
VICE PRESIDENT
8000 SKYHAR DRIVE
PORTLAND OR 97223

Officer/Director/Trustee Three

JOSEPHINE MCCLAIN
SECRETARY
PO BOX 808
BORING OR 97009

Officer/Director/Trustee Four

PAUL THARP
TREASURER
PO BOX 1094
ROCKAWAY BEACH OR 97136-1094

Officer/Director/Trustee Five

EDWARD WORTMAN
DIRECTOR
PO BOX 165
ROCKAWAY BEACH OR 97136-0165

Organization’s website INTERNATIONALPOLICEMUSEUM.ORG
Organization’s email IPMROCKAWAY@AOL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/10/2015
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A54 - History Museums
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 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
Signature Title
Signature Date

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