FORM 1023-EZ for HEALTHY YOUTH COALITION NORTH COUNTY

Field Data
EIN 82-4516122
Case Number EO-2018094-000202
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALTHY YOUTH COALITION NORTH COUNTY
Organization’s Mailing Address 288 MARTIN STREET BOX 1
City BLAINE
State WA
ZIP 98230
Accounting period End 12
Primary contact name ERIKA CREYDT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESSE CREYDT
PRESIDENT
8027 NISKA ROAD
BLAINE WA 98230

Officer/Director/Trustee Two

BRIAN GILBERT
VICE PRESIDENT
5574 SALISH ROAD
BLAINE WA 98230

Officer/Director/Trustee Three

JOYCE DIPPOLD
SECRETARY
7472 CLAMDIGGER DRIVE
BLAINE WA 98230

Officer/Director/Trustee Four

JAMES DANGER
TREASURER
4784 N GOLF COURSE DRIVE
BLAINE WA 98230

Officer/Director/Trustee Five

LAURA MARSHALL
BOARD MEMBER
5320 NOOTKA LOOP
BLAINE WA 98230

Organization’s website N/A
Organization’s email HYCOALITION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/21/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F21 - Alcohol, Drug Abuse, Prevention Only
Organization’s purpose Charitable: Yes
Religious: No
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JESSE CREYDT
Signature Title PRESIDENT
Signature Date 4/2/18

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