FORM 1023-EZ for SUSTAINABLE LIFE INTERNATIONAL

Field Data
EIN 84-2066733
Case Number EO-2019217-000204
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SUSTAINABLE LIFE INTERNATIONAL
Organization’s Mailing Address 16024 SE KELLY ST
City PORTLAND
State OR
ZIP 97236
Accounting period End 6
Primary contact name MAYME CAWVEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MAYME CAWVEY
BOARD PRESIDENT- EXECUTIVE DIRECTOR
SE KELLY ST
PORTLAND OR 97236

Officer/Director/Trustee Two

DANIEL DERRICK
BOARD MEMBER
11710 138TH ST CT EAST
PUYALLUP WA 98374

Officer/Director/Trustee Three

NEWTON GBORWAY
BOARD MEMBER
6942 SOUTH SPARROWTAIL RD
WEST JORDAN UT 84081

Officer/Director/Trustee Four

YETU DUMBIA
BOARD MEMBER
3330 ELLIS AVE NE
SALEM OR 97301

Officer/Director/Trustee Five

NANU SAYWON
BOARD MEMBER
3524 SE 159TH AVE
PORTLAND OR 97236

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/12/19
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 No
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MAYME CAWVEY
Signature Title BOARD PRESIDENT- EXECUTIVE DIRECTOR
Signature Date 7/31/19

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