FORM 1023-EZ for DOMINION HISTORICAL WORKBOAT ASSOCIATION

Field Data
EIN 47-3151326
Case Number EO-2015219-000276
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DOMINION HISTORICAL WORKBOAT ASSOCIATION
Organization’s Mailing Address 400 WASHINGTON AVENUE UNIT 311
City BREMERTON
State WA
ZIP 98337
Accounting period End 12
Primary contact name KAREN OSBORN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KAREN OSBORN
EXECUTIVE DIRECTOR
400 WASHINGTON AVE UNIT 311
BREMERTON WA 98337

Officer/Director/Trustee Two

STEVE ROHDE
PRESIDENT
14422 N EL PUEBLO BLVD
FOUNTAIN HILLS AZ 85268

Officer/Director/Trustee Three

SALLY PARKS
TREASURER
12308 9TH ST E
EDGEWOOD WA 98372

Officer/Director/Trustee Four

DAVE CLARKS
DIRECTOR
40 WASHIGTON AVENUE PMB 13
BREMERTON WA 98337

Officer/Director/Trustee Five

DAVID SMITH
DIRECTOR
24217 27TH AVENUE SOUTH UNIT D
DES MOINES WA 98198

Organization’s website HTTP://WWW.DOMINIONTUG.ORG/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/24/2015
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J22 - Vocational Training
Organization’s purpose Charitable: No
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 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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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