FORM 1023-EZ for JOHN HENRY MASON FOUNDATION

Field Data
EIN 82-1413330
Case Number EO-2018029-000382
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JOHN HENRY MASON FOUNDATION
Organization’s Mailing Address PO BOX 455
City SHAW ISLAND
State WA
ZIP 98286
Accounting period End 12
Primary contact name TERRI MASON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

REBECCA SMEMO
VICE PRESIDENT
PO BOX 455
SHAW ISLAND WA 98286

Officer/Director/Trustee Two

TERRI MASON
PRESIDENT
PO BOX 455
SHAW ISLAND WA 98286

Officer/Director/Trustee Three

CHLOE MASON
SOCIAL SERVICES
PO BOX 455
SHAW ISLAND WA 98286

Officer/Director/Trustee Four

SUSAN GAISER-GUDGELL
TREASURER
PO BOX 231
EASTSOUND WA 98245

Officer/Director/Trustee Five

JO GUDGELL
COMMUNICATIONS
PO BOX 231
EASTSOUND WA 98245

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/25/14
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F01 - Alliance/Advocacy Organizations
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TERRI MASON
Signature Title PRESIDENT
Signature Date 1/25/18

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