FORM 1023-EZ for BENTON CITY REVITALIZATION ORGANIZATION

Field Data
EIN 83-1616878
Case Number EO-2019038-001048
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BENTON CITY REVITALIZATION ORGANIZATION
Organization’s Mailing Address 1304 BABS AVE LOT 2
City BENTON CITY
State WA
ZIP 99320
Accounting period End 12
Primary contact name TIFFANY LEWIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DIANE LEIST
PRESIDENT
34102 N KENDALL RD NW
BENTON CITY WA 99320

Officer/Director/Trustee Two

MAXINE MARTIN
VICE PRESIDENT
506 CAROL
BENTON CITY WA 99320

Officer/Director/Trustee Three

TIFFANY LEWIS
SECRETARY/TREASURER
1304 BABS AVE LOT 2
BENTON CITY WA 99320

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/13/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TIFFANY LEWIS
Signature Title SECRETARY/TREASURER
Signature Date 1/26/19

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