FORM 1023-EZ for CARPATHIAN LEGACY

Field Data
EIN 47-2680189
Case Number EO-2015064-000260
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CARPATHIAN LEGACY
Organization’s Mailing Address 9824 121 AVE SE
City RENTON
State WA
ZIP 98056
Accounting period End 12
Primary contact name PETER CROW
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PETER CROW
INCORPORATOR
8924 121 AVE SE
RENTON WA 98056

Officer/Director/Trustee Two

JON SIMPSON
INCORPORATOR
8924 121 AVE SE
RENTON WA 98056

Officer/Director/Trustee Three

LESLIE GILBERTSON
ATTORNEY ON BEHALF OF
11033 NE 24TH ST STE 200
BELLEVUE WA 98004

Organization’s website
Organization’s email LESLIE.E.GILBERTSON@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/11/2014
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Q33 - International Relief
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 Yes
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
Signature Title
Signature Date

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