FORM 1023-EZ for CENTER FOR INTERCULTURAL WELLNESS
| Field | Data |
|---|---|
| EIN | 81-3890561 |
| Case Number | EO-2016273-000399 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | CENTER FOR INTERCULTURAL WELLNESS |
| Organization’s Mailing Address | 1920 SW WELLINGTON AVE |
| City | PORTLAND |
| State | OR |
| ZIP | 97225 |
| Accounting period End | 12 |
| Primary contact name | BRANDIE DIETERLE DELAHOZ |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
BAHER BUTTI
FOUNDER
1920 SW WELLINGTON AVE
PORTLAND OR 97225
Officer/Director/Trustee Two
BRANDIE DIETERLE DELAHOZ
FOUNDER
1035 SW 166TH AVE
BEAVERTON OR 97006-5582
Officer/Director/Trustee Three
MUWAFAQ ALKATTAN
FOUNDER
9301 SW SAGERT APT 196
TUALATIN OR 97062
Officer/Director/Trustee Four
RENSO BERNAL CRUZ-MUNOZ
FOUNDER
12335 SE SALMON ST
PORTLAND OR 97233
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 9/19/2016 |
| Organization Incorporation State | OR |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F32 - Community Mental Health Center |
| 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 | Yes |
| Donation of funds | Yes |
| 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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