FORM 1023-EZ for HENRIKSON HOMESCHOOL

Field Data
EIN 47-1822542
Case Number EO-2016012-000034
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HENRIKSON HOMESCHOOL
Organization’s Mailing Address 15999 SIDNEY RD SW
City PORT ORCHARD
State WA
ZIP 98367
Accounting period End 12
Primary contact name RACHEL HENRIKSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RACHEL HENRIKSON
DIRECTOR
15999 SIDNEY RD SW
PORT ORCHARD WA 98367

Officer/Director/Trustee Two

RACHEL HENRIKSON
PRESIDENT
15999 SIDNEY RD SW
PORT ORCHARD WA 98367

Officer/Director/Trustee Three

ERIK HENRIKSON
VICE PRESIDENT
15999 SIDNEY RD SW
PORT ORCHARD WA 98367

Officer/Director/Trustee Four

ERIK HENRIKSON
SECRETARY
15999 SIDNEY RD SW
PORT ORCHARD WA 98367

Officer/Director/Trustee Five

RACHEL HENRIKSON
TREASURER
15999 SIDNEY RD SW
PORT ORCHARD WA 98367

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/5/2014
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B90 - Educational Services and Schools - Other
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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