FORM 1023-EZ for HEROES HOMESTEAD

Field Data
EIN 82-5063004
Case Number EO-2019029-000794
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEROES HOMESTEAD
Organization’s Mailing Address 4779 GIBSON DAHL RD
City CLAYTON
State WA
ZIP 99110-9720
Accounting period End 12
Primary contact name DANIELLE HOLSTINE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DANIELLE HOLSTINE
BOARD MEMBER
4779 GIBSON DAHL RD
CLAYTON WA 99110-9720

Officer/Director/Trustee Two

KURT FULLER
BOARD MEMBER
1207 ALTA MESA DR
BREA CA 92821-1901

Officer/Director/Trustee Three

PAT HUMPHRIES
BOARD MEMBER
1711 E CHATTAROY
CHATTAROY WA 99003-8707

Officer/Director/Trustee Four

NA NA
NA
NA
NA WA 99999

Officer/Director/Trustee Five

NA NA
NA
NA
NA WA 99999

Organization’s website
Organization’s email DANIELLE@HEROESHOMESTEAD.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/3/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W30 - Military, Veterans' Organizations
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DANIELLE HOLSTINE
Signature Title BOARD MEMBER
Signature Date 12/18/18

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