FORM 1023-EZ for BREATHWORK NORTHWEST

Field Data
EIN 45-4134017
Case Number EO-2016032-000375
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BREATHWORK NORTHWEST
Organization’s Mailing Address 2413 TALBOT CREST DR SO
City RENTON
State WA
ZIP 98055
Accounting period End 12
Primary contact name HOLLY DANNUNZIO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GLENN GIRLANDO
PRESIDENT, DIRECTOR
1666 MARINE DR
BELLINGHAM WA 98225

Officer/Director/Trustee Two

CINDY PINKREIGN
SECRETARY, DIRECTOR
2413 TALBOT CREST DR SO
RENTON WA 98055

Officer/Director/Trustee Three

ERIC OLMSTED
DIRECTOR
12826 SE 245TH ST
KENT WA 98030

Officer/Director/Trustee Four

KEN GHALAMBOR
DIRECTOR
4411 WOODLAND PARK AVE N APT 4
SEATTLE WA 98103

Officer/Director/Trustee Five

HOLLY DANNUNZIO
TREASURER, DIRECTOR
621 PACIFIC AVE SUITE 216
TACOMA WA 98402

Organization’s website BREATHWORKNORTHWEST.ORG
Organization’s email ADMIN@BREATHWORKNORTHWEST.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/29/2011
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative N.E.C.
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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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