FORM 1023-EZ for LIGHTHOUSE FAMILY MINISTRIES NORTHWEST

Field Data
EIN 46-2942522
Case Number EO-2015026-000367
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIGHTHOUSE FAMILY MINISTRIES NORTHWEST
Organization’s Mailing Address PO BOX 13593
City DES MOINES
State WA
ZIP 98198
Accounting period End 12
Primary contact name SARAH TUTTLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SARAH TUTTLE
BOARD PRESIDENT
PO BOX 13593
DES MOINES WA 98198

Officer/Director/Trustee Two

ANNA PRINGLE
BOARD TREASURER
PO BOX 13593
DES MOINES WA 98198

Officer/Director/Trustee Three

BOBBIE JO SHOCKLEY
BOARD VICE PRESIDENT
PO BOX 13593
DES MOINES WA 98198

Officer/Director/Trustee Four

AMBER BURMEISTER
BOARD SECRETARY
PO BOX 13593
DES MOINES WA 98198

Officer/Director/Trustee Five

ANITA MORGENROTH
TECHNOLOGY DIRECTOR
PO BOX
DES MOINES WA 98198

Organization’s website WWW.LHFM.ORG
Organization’s email SARAH@LHFM.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/7/2013
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P43 - Family Violence Shelters, Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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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