FORM 1023-EZ for ICAN

Field Data
EIN 82-4079881
Case Number EO-2018029-000480
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ICAN
Organization’s Mailing Address 17328 121ST LANE SE SUITE TT302
City RENTON
State WA
ZIP 98058
Accounting period End 12
Primary contact name TRACY LEE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRACY LEE
PRESIDENT/TREASURER/DIRECTOR
17328 121ST LANE SE SUITE TT302
RENTON WA 98058

Officer/Director/Trustee Two

DERRICK ESKRIDGE
SECRETARY/DIRECTOR
813 S 14TH STREET
TACOMA WA 98405

Officer/Director/Trustee Three

GURLINE ELLIOTT
DIRECTOR
14500 ADMIRALITY WAY APT 203
LYNNWOOD WA 98087

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/11/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J20 - Employment Procurement Assistance, Job Training
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TRACY LEE
Signature Title PRESIDENT/TREASURER/DIRECTOR
Signature Date 1/26/18

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