| Field | Data |
|---|---|
| EIN | 84-2914261 |
| Case Number | EO-2019266-000596 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | THE ORIGINAL THEATRE BLACK DOG |
| Organization’s Mailing Address | 215 FRONT ST N UNIT 6 |
| City | ISSAQUAH |
| State | WA |
| ZIP | 98027 |
| Accounting period End | 12 |
| Primary contact name | ANTHONY FLOYD |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
ANTHONY FLOYD
PRESIDENT
11332 20TH AVE NE
SEATTLE WA 98125
KAREN BEISNER
TREASURER
9910 - 163RD AVE NE
REDMOND WA 98052
SUSAN ARNOLD
SECRETARY
480 NE ALDER ST
ISSAQUAH WA 98027
SUSAN BRADFORD
INCORPORATOR
215 FRONT ST N UNIT 6
ISSAQUAH WA 98027
PATTI DARCHUK
INCORPORATOR
215 FRONT ST N UNIT 9
ISSAQUAH WA 98027
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 7/29/19 |
| Organization Incorporation State | WA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | A65 - Theater |
| Organization’s purpose | Charitable: No Religious: No Educational: No Scientific: No Literary: Yes 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 | ANTHONY FLOYD |
| Signature Title | PRESIDENT |
| Signature Date | 9/21/19 |
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