FORM 1023-EZ for MIRACLE EMBRYO FOUNDATION

Field Data
EIN 81-1104538
Case Number EO-2019256-000043
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MIRACLE EMBRYO FOUNDATION
Organization’s Mailing Address 4445 382ND AVENUE SE
City SNOQUALMIE
State WA
ZIP 98065
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 $275.00
Officer/Director/Trustee One

PATRICIA JOHNSON
TRUSTEE
1516 WEST B AVE
LA CENTER WA 98629

Officer/Director/Trustee Two

MARIA LANCASTER
PRESIDENT
4445 382ND AVENUE SE
SNOQUALMIE WA 98065

Officer/Director/Trustee Three

CINDI ROMINE
SECRETARY-TREASURER
4445 382ND AVENUE SE
SNOQUALMIE WA 98065

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/11/15
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P31 - Adoption
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MARIA LANCASTER
Signature Title PRESIDENT
Signature Date 9/9/19

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