FORM 1023-EZ for CONNECT 2 BLESS

Field Data
EIN 47-2416825
Case Number EO-2015009-000342
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CONNECT 2 BLESS
Organization’s Mailing Address 12718 SE PARK ST
City VANCOUVER
State WA
ZIP 98683
Accounting period End 12
Primary contact name PATRICIA JOHNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT HIRTZEL
PRESIDENT
12718 SE PARK ST
VANCOUVER WA 98683

Officer/Director/Trustee Two

SUSAN HIRTZEL
VICE PRESIDENT
12718 SE PARK ST
VANCOUVER WA 98683

Officer/Director/Trustee Three

SAM TEAS
SECT-TREASURER
12718 SE PARK ST
VANCOUVER WA 98683

Organization’s website
Organization’s email RSHIRTIZEL@COMCAST.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/23/2014
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P50 - Personal Social Services
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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