FORM 1023-EZ for SOUL CAFE

Field Data
EIN 46-2952066
Case Number EO-2016328-000219
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SOUL CAFE
Organization’s Mailing Address 109 W MAIN AVE
City RITZVILLE
State WA
ZIP 99169
Accounting period End 12
Primary contact name CORY BARTLETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARIE BORTH
PRESIDENT
PO BOX 355
RITZVILLE WA 99169

Officer/Director/Trustee Two

JENNIFER VERHEY
VICE PRESIDENT
1107 S PAR DRIVE
RITZVILLE WA 99169

Officer/Director/Trustee Three

CORY BARTLETT
TREASURER
310 E 2ND AVE
RITZVILLE WA 99169

Officer/Director/Trustee Four

MELODY BARTLETT
SECRETARY
310 E 2ND AVE
RITZVILLE WA 99169

Officer/Director/Trustee Five

RON NEWTON
OFFICER AT LARGE
509 E 4TH AVE
RITZVILLE WA 99169

Organization’s website
Organization’s email SCRITZVILLE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/8/2013
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date
EIN 46-2952066
Case Number EO-2015096-000147
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SOUL CAFE
Organization’s Mailing Address 109 WEST MAIN AVE
City RITZVILLE
State WA
ZIP 99169
Accounting period End 12
Primary contact name BROOKE HAYS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARIE BORTH
CHAIRMAN
PO BOX 355
RITZVILLE WA 99169

Officer/Director/Trustee Two

DEIDRE RAWLINGS
VICE CHAIRMAN
308 E ALDER
RITZVILLE WA 99169

Officer/Director/Trustee Three

KAY FRESH
SECRETARY
104 E SECOND AVE APT 11
RITZVILLE WA 99169

Officer/Director/Trustee Four

BROOKE HAYS
TREASURER
105 W 5TH AVE
RITZVILLE WA 99169

Officer/Director/Trustee Five

RON NEWTON
CO TREASUER
506 E 4TH AVE
RITZVILLE WA 99169

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/8/2013
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X99 - Religion Related, Spiritual Development N.E.C.
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 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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