FORM 1023-EZ for RECLAIMING LIVES

Field Data
EIN 47-4639746
Case Number EO-2015229-000218
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RECLAIMING LIVES
Organization’s Mailing Address 4012 NE ST JOHNS BLVD
City VANCOUVER
State WA
ZIP 98661
Accounting period End 12
Primary contact name PATRICIA JOHNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

EVELYN WOODHURST
PRESIDENT
4012 NE ST JOHNS BLVD
VANCOUVER WA 98661

Officer/Director/Trustee Two

NICOLE SIMON
VICE PRESINENT
4012 NE ST JOHNS BLVD
VANCOUVER WA 98661

Officer/Director/Trustee Three

PENDING PENDING
SECTTREASURER
4012 NE ST JOHNS BLVD
VANCOUVER WA 98661

Organization’s website
Organization’s email RECLAIMINGLIVES.PNW@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/6/2015
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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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