FORM 1023-EZ for COLLINS HOUSE

Field Data
EIN 46-5576290
Case Number EO-2017263-000221
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COLLINS HOUSE
Organization’s Mailing Address 123 KIRKLAND RD
City LONGVIEW
State WA
ZIP 98632
Accounting period End 12
Primary contact name CINDY BRADO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICIA COLLINS
PRESIDENT
123 KIRKLAND RD
LONGVIEW WA 98632

Officer/Director/Trustee Two

MICHELLE TAYLOR
VICE PRESIDENT
417 26TH AVENUE
LONGVIEW WA 98632

Officer/Director/Trustee Three

SANDY GASKILL
SECRETARY
900 GRADE STREET APT 54
KELSO WA 98626

Officer/Director/Trustee Four

JANE SCHAAF
TREASURER
2943 LAUREL RD
LONGVIEW WA 98632

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/28/2014
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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