FORM 1023-EZ for LEWIS COUNTY AUTISM COALTION

Field Data
EIN 47-3931045
Case Number EO-2015134-000347
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LEWIS COUNTY AUTISM COALTION
Organization’s Mailing Address 450 NW PACIFIC AVE
City CHEHALIS
State WA
ZIP 98532
Accounting period End 12
Primary contact name WILLIAM WEISMANN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

APRIL KELLEY
CO-CHAIR
360 NW NORTH ST
CHEHALIS WA 98532

Officer/Director/Trustee Two

CRISTI HEITSCHMIDT
CO-CHAIR
220 S ROCK ST
CENTRALIA WA 98532

Officer/Director/Trustee Three

LINDA LEE
TREASURER
450 NW PACIFIC AVE
CHEHALIS WA 98532

Officer/Director/Trustee Four

AMANDA PROTHERO
CO-SECRETARY
1673 S MARKET ST 216
CHEHALIS WA 98532

Officer/Director/Trustee Five

TRISHA QUICK
CO-SECRETARY
PO BOX 295
ADNA WA 98522

Organization’s website WWW.LCAUTISM.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/28/2014
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G84 - Autism
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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