FORM 1023-EZ for CANNABIS PATIENTS PNW

Field Data
EIN 85-1711902
Case Number EO-2020317-000565
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CANNABIS PATIENTS PNW
Organization’s Mailing Address 4504 NE 49TH STREET
City VANCOUVER
State WA
ZIP 98661-2634
Accounting period End 12
Primary contact name DAVID BENEDICKTUS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID BENEDICKTUS
PRESIDENT
P O BOX 1386
VANCOUVER WA 98661-2634

Officer/Director/Trustee Two

JEREMY ROBBINS
VICE PRESIDENT
P O BOX 1386
VANCOUVER WA 98661-2634

Officer/Director/Trustee Three

CAROL STIFF
TREASURER
P O BOX 1386
VANCOUVER WA 99113

Officer/Director/Trustee Four

TESSA TOVAR
SECRETARY
P O BOX 1386
VANCOUVER WA 98661-2634

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/19/2020
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E06 -
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 CAROL STIFF
Signature Title TREASURER
Signature Date 11/10/2020

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