FORM 1023-EZ for MOONRISE WELLNESS & BIRTH CENTER

Field Data
EIN 83-1510443
Case Number EO-2018232-000201
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOONRISE WELLNESS & BIRTH CENTER
Organization’s Mailing Address 20033 32ND AVE NE
City LAKE FOREST PARK
State WA
ZIP 98155
Accounting period End 12
Primary contact name BRANDY ROSS-BELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRANDY ROSS-BELL
PRESIDENT/DIRECTOR
20033 32ND AVE NE
LAKE FOREST PARK WA 98155

Officer/Director/Trustee Two

KATE DEWEY
VICE-PRESIDENT/TREASURER
20113 32ND AVE NE
LAKE FOREST PARK WA 98155

Officer/Director/Trustee Three

AMY COLLINS
SECRETARY/DIRECTOR
4210 198TH ST SW SUITE 100
LYNNWOOD WA 98036

Organization’s website
Organization’s email INFO@MOONRISEHEALTH.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/14/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 BRANDY ROSS-BELL
Signature Title PRESIDENT/DIRECTOR
Signature Date 8/16/18

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