FORM 1023-EZ for BALANCED ELEMENTS ACUPUNCTURE & CHINESE HERBAL MEDICINE
| Field | Data |
|---|---|
| EIN | 86-2720523 |
| Case Number | EO-2021099-001620 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | BALANCED ELEMENTS ACUPUNCTURE & CHINESE HERBAL MEDICINE |
| Organization’s Mailing Address | 15314 4TH AVE SW SUITE A |
| City | BURIEN |
| State | WA |
| ZIP | 98166 |
| Accounting period End | 12 |
| Primary contact name | DIONEA NADIR |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
DIONEA NADIR
DIRECTOR
654 SW 130TH ST
BURIEN WA 98146
Officer/Director/Trustee Two
XAN SCOTT
PRESIDENT
2920 SE WAVERLEIGH BLVD APT 9
PORTLAND OR 97202
Officer/Director/Trustee Three
LEO SCHMIDT
TREASURER
2106 S 124TH ST
BURIEN WA 98168
Officer/Director/Trustee Four
KEN CLARK
SECRETARY
654 SW 130TH ST
BURIEN WA 98146
| Organization’s website | BE-ACUPUNCTURE.COM |
|---|---|
| Organization’s email | BE.ACUPUNCTURECLINIC@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 3/1/2021 |
| Organization Incorporation State | WA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E30 - Health Treatment Facilities, Primarily Outpatient |
| Organization’s purpose | Charitable: Yes Religious: No Educational: No Scientific: Yes 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 | Yes |
| Financial transactions with officers | No |
| Unrelated Gross Income $1,000 or More | No |
| Gaming Activity | No |
| Disaster relief assistance | Yes |
| 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 | DIONEA NADIR |
| Signature Title | DIRECTOR |
| Signature Date | 3/21/2021 |
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