FORM 1023-EZ for PACIFIC SAMI SEARVI

Field Data
EIN 82-4161173
Case Number EO-2020093-000285
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PACIFIC SAMI SEARVI
Organization’s Mailing Address 5706 17TH AVE NW POB 17482
City SEATTLE
State WA
ZIP 98107
Accounting period End 12
Primary contact name JULIE J WHITEHORN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JULIE WHITEHORN
PRESIDENT
2207 3RD AVENUE WEST
SEATTLE WA 98119

Officer/Director/Trustee Two

JESSICA WEAPPA
VICE-PRESIDENT
645 MOJI LANE NW
BAINBRIDGE ISLAND WA 98110

Officer/Director/Trustee Three

ARIEL FELTON
SECRETARY
7327 29TH STREET
SEATTLE WA 98126

Officer/Director/Trustee Four

CHRISTIN CURRAN
DIRECTOR
6220 WOODLAND AVE N
SEATTLE WA 98103

Officer/Director/Trustee Five

TROY STORFJELL
CULTURAL ADVISOR
1724 N OAKES STREET
TACOMA WA 98406

Organization’s website PACIFICSAMISEARVI.ORG
Organization’s email PACIFICSAMISEARVI@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/25/2018
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
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 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 JULIE WHITEHORN
Signature Title PRESIDENT
Signature Date 3/31/2020

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