FORM 1023-EZ for TOTEM DIAMOND CLUB

Field Data
EIN 82-5208592
Case Number EO-2018109-000712
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TOTEM DIAMOND CLUB
Organization’s Mailing Address 227 BELLEVUE WAY NE NUM 610
City BELLEVUE
State WA
ZIP 98004-5721
Accounting period End 2
Primary contact name SHANE OLSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHANE OLSEN
PRESIDENT
227 BELLEVUE WAY NE NUM 610
BELLEVUE WA 98004-5721

Officer/Director/Trustee Two

STEVE HAMADA
TREASURER
1822 138TH PL SE
BELLEVUE WA 98005-4024

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/17/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: Yes
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 SHANE OLSEN
Signature Title PRESIDENT
Signature Date 4/17/18

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