FORM 1023-EZ for POLK COUNTY CLAY TARGET LEAGUE

Field Data
EIN 84-3597027
Case Number EO-2019312-000030
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name POLK COUNTY CLAY TARGET LEAGUE
Organization’s Mailing Address 385 53RD AVE NW
City SALEM
State OR
ZIP 97304
Accounting period End 12
Primary contact name JOSEPH FITTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICK PIPPIN
PRESIDENT
297 N PACIFIC HWY WEST
MONMOUTH OR 97361

Officer/Director/Trustee Two

VINCENT BORDADORA
VICE PRESIDENT
385 53RD AVE NW
SALEM OR 97304

Officer/Director/Trustee Three

ABIGAIL FITTS
SECRETARY
7880 BUENA VISTA RD
INDEPENDENCE OR 97351

Officer/Director/Trustee Four

JOSEPH FITTS
TREASURER
7880
INDE OR 97351

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/25/19
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 JOSEPH FITTS
Signature Title TREASURER
Signature Date 11/6/19

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