FORM 1023-EZ for APPLEWOOD PERINATAL CARE

Field Data
EIN 47-2507094
Case Number EO-2015261-000210
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name APPLEWOOD PERINATAL CARE
Organization’s Mailing Address 4599 DEERHORN TRAIL
City BREMERTON
State WA
ZIP 98311
Accounting period End 6
Primary contact name ANNIE MOFFAT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KRISTINA KRUZAN
PRESIDENT
4599 DEERHORN TRAIL
BREMERTON WA 98311

Officer/Director/Trustee Two

ANNIE MOFFAT
DIRECTOR
9222 FLETCHER BAY RD NE
BAINBRIDGE ISLAND WA 98110

Officer/Director/Trustee Three

JULIE BENNET
TREASURER
EAGLE HARBOR DRIVE
BAINBRIDGE ISLAND WA 98110

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/28/2014
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 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 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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