FORM 1023-EZ for GRACE BELIEVERS SOCIETY - USA

Field Data
EIN 83-4684173
Case Number EO-2019142-000184
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GRACE BELIEVERS SOCIETY - USA
Organization’s Mailing Address 1354 COUNTRY CLUB DR
City CAMANO ISLAND
State WA
ZIP 98282
Accounting period End 12
Primary contact name VICKI BURGESS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAUL BURGESS
PRESIDENT/DIRECTOR
1354 COUNTRY CLUB DR
CAMANO ISLAND WA 98282

Officer/Director/Trustee Two

VICKI BURGESS
SECRETARY/DIRECTOR
1354 COUNTRY CLUB DR
CAMANO ISLAND WA 98282

Officer/Director/Trustee Three

SAJID AZEEM
VICE-PRESIDENT/DIRECTOR
1354 COUNTRY CLUB DR
CAMANO ISLAND WA 98282

Officer/Director/Trustee Four

SIDRA EJAZ
TREASURER/DIRECTOR
1354 COUNTRY CLUB DR
CAMANO ISLAND WA 98282

Officer/Director/Trustee Five

YASHWA VISHAL
DIRECTOR
1354 COUNTRY CLUB DR
CAMANO ISLAND WA 98282

Organization’s website
Organization’s email VBURGESS28@OUTLOOK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/17/19
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
Donation of funds No
Conducting Activities Outside of United States Yes
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 VICKI BURGESS
Signature Title SECRETARY/DIRECTOR
Signature Date 5/20/19

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