FORM 1023-EZ for HEALTHY DECISIONS

Field Data
EIN 27-1327789
Case Number EO-2019058-000254
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALTHY DECISIONS
Organization’s Mailing Address 532 NE 3RD NO 101
City CAMAS
State WA
ZIP 98607-2171
Accounting period End 12
Primary contact name SUSANNE RODRIGUEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICHARD PAIGE
PRESIDENT & DIRECTOR
532 NE 3RD NO 101
CAMAS WA 98607-2171

Officer/Director/Trustee Two

MIKE WILLBUR
SECRETARY & DIRECTOR
532 NE 3RD NO 101
CAMAS WA 98607-2171

Officer/Director/Trustee Three

SUSANNE RODRIGUEZ
TREASURER & DIRECTOR
532 NE 3RD NO 101
CAMAS WA 98607-2171

Organization’s website HTTP://HEALTHYDECISIONS-WA.ORG/WP/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/25/19
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I71 - Spouse Abuse, Prevention of
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SUSANNE RODRIGUEZ
Signature Title TREASURER & DIRECTOR
Signature Date 2/25/19

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