FORM 1023-EZ for COFFIN-SIRIS SYNDROME FOUNDATION
| Field | Data |
|---|---|
| EIN | 82-2116961 |
| Case Number | EO-2018029-000591 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | COFFIN-SIRIS SYNDROME FOUNDATION |
| Organization’s Mailing Address | 11611 106TH AVE NE |
| City | KIRKLAND |
| State | WA |
| ZIP | 98034 |
| Accounting period End | 12 |
| Primary contact name | JONATHAN ROBINSON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
JONATHAN ROBINSON
BOARD MEMBER
11611 106TH AVE NE
KIRKLAND WA 98034-3934
Officer/Director/Trustee Two
BENJI ROSENZWEIG
BOARD MEMBER
3959 NORMANWOOD
WEST BLOOMFIELD MI 48323-1746
Officer/Director/Trustee Three
BRION JOHANSEN
BOARD MEMBER
9777 SOUTH DAVID STREET
SANDY UT 84070-3584
Officer/Director/Trustee Four
MARIA RIOJAS
BOARD MEMBER
6739 39TH AVE SW
SEATTLE WA 98136-1902
Officer/Director/Trustee Five
YARIXZA CAMACHO
BOARD MEMBER
1213 GLENMORE DRIVE
PASADENA TX 77503-2701
| Organization’s website | COFFINSIRIS.ORG |
|---|---|
| Organization’s email | COFFINSIRIS@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 12/18/17 |
| Organization Incorporation State | WA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | G20 - Birth Defects and Genetic Diseases |
| 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 | JONATHAN ROBINSON |
| Signature Title | BOARD MEMBER |
| Signature Date | 1/27/18 |
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