FORM 1023-EZ for SKAGIT AND ISLAND COUNTIES COUNCILOF THE BLIND

Field Data
EIN 81-3313250
Case Number EO-2016274-000179
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SKAGIT AND ISLAND COUNTIES COUNCILOF THE BLIND
Organization’s Mailing Address 2117 O AVENUE
City ANACORTES
State WA
ZIP 98221-2567
Accounting period End 12
Primary contact name ANDREW A ARVIDSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDREW ARVIDSON
PRESIDENT
2117 O AVENUE
ANACORTES WA 98221-2567

Officer/Director/Trustee Two

TRAVIS SMART
1ST VICE PRESIDENT
466 S NORRIS ST APT 109
BURLINGTON WA 98233-3731

Officer/Director/Trustee Three

PHILIP BLEYHL
2ND VICE PRESIDENT
1350 SE PIONEER WAY
OAK HARBOR WA 98277-5434

Officer/Director/Trustee Four

TERRI DOWNING
SECRETARY
2121 S CEDAR HILLS DR
MOUNT VERNON WA 98274-9000

Officer/Director/Trustee Five

COLETTE ARVIDSON
TREASURER
2117 O AVENUE
ANACORTES WA 98221-2567

Organization’s website
Organization’s email AAARVIDSON@EARTHLINK.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/21/2016
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 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 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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