FORM 1023-EZ for APPLICATION COMMUNICATION AND SECURITY INITIATIVE

Field Data
EIN 82-4106297
Case Number EO-2018309-000192
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name APPLICATION COMMUNICATION AND SECURITY INITIATIVE
Organization’s Mailing Address 117 E LOUISA ST SUITE 172
City SEATTLE
State WA
ZIP 98102
Accounting period End 12
Primary contact name JOHN CAMPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN CAMPA
PRESIDENT
117 E LOUISA ST SUITE 172
SEATTLE WA 98102

Officer/Director/Trustee Two

JC FERGUSON
VICE PRESIDENT AND DIRECTOR
117 E LOUISA ST SUITE 172
SEATTLE WA 98102

Officer/Director/Trustee Three

ANDREW JENKINS
TREASURER AND DIRECTOR
117 E LOUISA ST SUITE 172
SEATTLE WA 98102

Officer/Director/Trustee Four

SHAWN WORMKE
SECRETARY
117 E LOUISA ST SUITE 172
SEATTLE WA 98102

Officer/Director/Trustee Five

JESSE DEMMEL
DIRECTOR
117 E LOUISA ST SUITE 172
SEATTLE WA 98102

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/21/17
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code U19 - Nonmonetary Support N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 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 JOHN CAMPA
Signature Title PRESIDENT
Signature Date 11/1/18

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