FORM 1023-EZ for STRONG4SAM

Field Data
EIN 47-3755104
Case Number EO-2015203-000247
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name STRONG4SAM
Organization’s Mailing Address 25823 SE 31ST PL
City SAMMAMISH
State WA
ZIP 98075
Accounting period End 12
Primary contact name JEFF TAYLOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MIKE CRISP
PRESIDENT
4029 239TH PL SE
ISSAQUAH WA 98029

Officer/Director/Trustee Two

KELLEA TAYLOR
VICE PRESIDENT
25823 SE 31ST PL
SAMMAMISH WA 98075

Officer/Director/Trustee Three

JEFF TAYLOR
VICE PRESIDENT
25823 SE 31ST PL
SAMMAMISH WA 98075

Officer/Director/Trustee Four

TRACY KISTNER
TREASURER
26632 SE 15TH ST
SAMMAMISH WA 98075

Officer/Director/Trustee Five

LISA NOONAN
SECRETARY
23017 SE 41ST CT
SAMMAMISH WA 98075

Organization’s website WWW.STRONG4SAM.ORG
Organization’s email INFO@STRONG4SAM.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/21/2015
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H12 - Fund Raising and/or Fund Distribution
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
Signature Title
Signature Date

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