FORM 1023-EZ for COASTAL LAW ENFORCEMENT CHAPLAINCY

Field Data
EIN 83-2143645
Case Number EO-2018283-000377
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COASTAL LAW ENFORCEMENT CHAPLAINCY
Organization’s Mailing Address PO BOX 865
City OCEAN PARK
State WA
ZIP 98640-865
Accounting period End 12
Primary contact name SAMANTHA HUMPHREY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SAMANTHA HUMPHREY
DIRECTOR
PO BOX 865
OCEAN PARK WA 98640-865

Officer/Director/Trustee Two

ALAN HUMPHREY
CO-DIRECTOR
PO BOX 865
OCEAN PARK WA 98640-865

Organization’s website
Organization’s email CHAPLAINSAMIAM@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/8/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X19 - Nonmonetary Support N.E.C.
Organization’s purpose Charitable: No
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 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 SAMANTHA HUMPHREY
Signature Title DIRECTOR
Signature Date 10/8/18

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