FORM 1023-EZ for ORCHID COUNSELING SERVICES

Field Data
EIN 82-5064922
Case Number EO-2018285-000196
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ORCHID COUNSELING SERVICES
Organization’s Mailing Address 801 2ND AVE SUITE 800
City SEATTLE
State WA
ZIP 98104
Accounting period End 12
Primary contact name TALIA KUYKENDALL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TALIA KUYKENDALL
OFFICER
320 SOUTH 314TH PLACE
FEDERAL WAY WA 98003

Officer/Director/Trustee Two

RYAN HORDE
DIRECTOR OF BOARD
19624 68TH AVE W APT 218
LYNWOOD WA 98036

Officer/Director/Trustee Three

MORGAN FISKEVOLD
TREASURER
320 SOUTH 314TH PLACE
FEDERAL WAY WA 98003

Officer/Director/Trustee Four

DEBORAH BARNARD
SECRETARY OF BOARD
1731 N 128TH ST
SEATTLE WA 98133

Officer/Director/Trustee Five

MIELKE SKLAR-OBER
GENERAL BOARD MEMBER
12311 32TH AVE NE APT 511
SEATTLE WA 98125

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/5/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F30 - Mental Health Treatment - Multipurpose and N.E.C.
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 TALIA KUYKENDALL
Signature Title OFFICER
Signature Date 10/10/18

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