FORM 1023-EZ for COMMUNITY CAFE COLLABORATIVE

Field Data
EIN 81-4800922
Case Number EO-2016365-000242
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COMMUNITY CAFE COLLABORATIVE
Organization’s Mailing Address 12726 27TH AVE NE
City SEATTLE
State WA
ZIP 98125
Accounting period End 12
Primary contact name ROBIN HIGA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBIN HIGA
CHIEF EXECUTIVE OFFICER
12726 27TH AVE NE
NEW YORK NY 10009

Officer/Director/Trustee Two

JOEL HIGA
BOARD OF DIRECTOR
9 STUYVESANT OVAL APT 3D
NEW YORK NY 10009

Officer/Director/Trustee Three

JOAN SHARP
BOARD OF DIRECTORS
2050 JAMIESON AVENUE 1309
ALEXANDRIA VA 22314

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2007
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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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