FORM 1023-EZ for 4-CORNERSORG

Field Data
EIN 27-5563193
Case Number EO-2016365-000315
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name 4-CORNERSORG
Organization’s Mailing Address 641 NW 175TH STREET
City SHORELINE
State WA
ZIP 98177-3701
Accounting period End 12
Primary contact name WILLIAM MONTERO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIAM MONTERO
DIRECTOR
641 NW 175TH STREET
SHORELINE WA 98177-3701

Officer/Director/Trustee Two

LISA SUROWIEC
DIRECTOR
17804 6TH AVENUE NW
SHORELINE WA 98177

Officer/Director/Trustee Three

PETE GERHARD
DIRECTOR
18521 6TH AVENUE NW
SHORELINE WA 98177

Organization’s website HTTP://WWW.4-CORNERS.ORG/
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/8/2011
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A12 - Fund Raising and/or Fund Distribution
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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