FORM 1023-EZ for GLACIER PEAK HS BOYS SWIM & DIVE -GPHS SWIM TEAM

Field Data
EIN 46-3096530
Case Number EO-2019200-000370
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GLACIER PEAK HS BOYS SWIM & DIVE -GPHS SWIM TEAM
Organization’s Mailing Address 1523 132ND ST SE SUITE C NO 409
City EVERETT
State WA
ZIP 98208
Accounting period End 7
Primary contact name SHANNON LISENBY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHANNON LISENBY
CO-PRESIDENT
11801 SEATTLE HILL RD
SNOHOMISH WA 98296

Officer/Director/Trustee Two

SHAUN LISENBY
CO-PRESIDENT
11801 SEATTLE HILL RD
SNOHOMISH WA 98296

Officer/Director/Trustee Three

HEATHER GEORGE
TREASURER
12722 71ST DR SE
SNOHOMISH WA 98296

Officer/Director/Trustee Four

MICHELLE ERICKSON
SECRETARY
18710 117TH AVE SE
SNOHOMISH WA 98296

Organization’s website
Organization’s email GPHSANDSHSBOYSSWIMANDDIVE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/13
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - 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 Yes
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 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 SHANNON LISENBY
Signature Title CO-PRESIDENT
Signature Date 7/17/19
EIN 46-3096530
Case Number EO-2019200-000370
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GLACIER PEAK HS BOYS SWIM & DIVE - GPHS SWIM TEAM
Organization’s Mailing Address 1523 132ND ST SE SUITE C NO 409
City EVERETT
State WA
ZIP 98208
Accounting period End 7
Primary contact name SHANNON LISENBY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHANNON LISENBY
CO-PRESIDENT
11801 SEATTLE HILL RD
SNOHOMISH WA 98296

Officer/Director/Trustee Two

SHAUN LISENBY
CO-PRESIDENT
11801 SEATTLE HILL RD
SNOHOMISH WA 98296

Officer/Director/Trustee Three

HEATHER GEORGE
TREASURER
12722 71ST DR SE
SNOHOMISH WA 98296

Officer/Director/Trustee Four

MICHELLE ERICKSON
SECRETARY
18710 117TH AVE SE
SNOHOMISH WA 98296

Organization’s website
Organization’s email GPHSANDSHSBOYSSWIMANDDIVE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/13
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - 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 Yes
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 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 SHANNON LISENBY
Signature Title CO-PRESIDENT
Signature Date 7/17/19

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