FORM 1023-EZ for BREAK THE BARRIER

Field Data
EIN 87-2301427
Case Number EO-2021238-000420
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BREAK THE BARRIER
Organization’s Mailing Address 13610 SE 7TH ST
City BELLEVUE
State WA
ZIP 98005-3709
Accounting period End 12
Primary contact name ANDREW SHAW
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDREW SHAW
PRESIDENT
13610 SE 7TH ST
BELLEVUE WA 98005-3709

Officer/Director/Trustee Two

NEO CAI
SECRETARY
4156 187TH AVE SE
ISSAQUAH WA 98027-9743

Organization’s website
Organization’s email IHSBREAKTHEBARRIER@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/19/2021
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B99 - Education 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 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 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 ANDREW SHAW
Signature Title PRESIDENT
Signature Date 8/24/2021

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