FORM 1023-EZ for ARKROCK ACADEMY

Field Data
EIN 81-2374815
Case Number EO-2016123-000237
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ARKROCK ACADEMY
Organization’s Mailing Address 24035 NE 30TH PLACE
City SAMMAMISH
State WA
ZIP 98074
Accounting period End 12
Primary contact name SUSHMA MUTHABATULLA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SUSHMA K PAKALAPATI MUTHABATULLA
PRESIDENT
24035 NE 30TH PLACE
SAMMAMISH WA 98074

Officer/Director/Trustee Two

JULIE BRUNK
SECRETARY
14434 NE 8TH ST
BELLEVUE WA 98007

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/14/2016
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B21 - Kindergarten, Preschool, Nursery School, Early Admissions
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
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 Yes
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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