FORM 1023-EZ for FIVE SENSES FOUNDATION

Field Data
EIN 47-2065133
Case Number EO-2017171-000340
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FIVE SENSES FOUNDATION
Organization’s Mailing Address 3212 ARAPAHOE PL W
City SEATTLE
State WA
ZIP 98199-2536
Accounting period End 12
Primary contact name AKEMI SAGAWA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AKEMI SAGAWA
PRESIDENT
3212 ARAPAHOE PL W
SEATTLE WA 98199-2536

Officer/Director/Trustee Two

TIM PAUL
SECRETARY
6021 45TH AVE SW
SEATTLE WA 98136-1426

Officer/Director/Trustee Three

SUMIE NAKAGAWA
DIRECTOR
19626 WAPATO LANE STE 208
POULSBO WA 98370-6343

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/3/2017
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 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
Signature Title
Signature Date

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