FORM 1023-EZ for ONE SPIRIT MEDICAL MISSION

Field Data
EIN 45-2629735
Case Number EO-2020260-000323
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ONE SPIRIT MEDICAL MISSION
Organization’s Mailing Address PO BOX 31565
City BELLINGHAM
State WA
ZIP 98228-3565
Accounting period End 12
Primary contact name KIMBERLY SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEFF LARSON
CO-CHAIRMAN
707 E MAYBERRY
LYNDEN WA 98264

Officer/Director/Trustee Two

JAME BOCHSLER
CO-CHAIRMAN
4614 ANDERSON WAY
BELLINGHAM WA 98226

Officer/Director/Trustee Three

SCOTT BROWN
SECRETARY
5928 ASPEN S
FERNDALE WA 98248

Officer/Director/Trustee Four

KIMBERLY SMITH
TREASURER
2119 MICHIGAN ST
BELLINGHAM WA 98229

Officer/Director/Trustee Five

DAVE VEENBAAS
BOARD MEMBER
2117 ST CLAIR ST
BELLINGHAM WA 98229

Organization’s website WWW.ONESPIRITMEDICAL.ORG
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/15/2011
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KIMBERLY SMITH
Signature Title TREASURER
Signature Date 9/14/2020

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