FORM 1023-EZ for CHEMICAL DEPENDENCY TRAINING CONSORTIUM OF SOUTHWEST WASHINGTON

Field Data
EIN 26-3884882
Case Number EO-2016102-000196
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHEMICAL DEPENDENCY TRAINING CONSORTIUM OF SOUTHWEST WASHINGTON
Organization’s Mailing Address PO BOX 847
City VANCOUVER
State WA
ZIP 98666
Accounting period End 3
Primary contact name LISA WESTLUND
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GUADALUPE ARAGON
PRESIDENT
617 SE 121ST AVE UNIT 12
VANCOUVER WA 98683

Officer/Director/Trustee Two

T BIRD
PRESIDENT-ELECT
1312 SW WASHINGTON ST
PORTLAND OR 97208

Officer/Director/Trustee Three

REED E PALMER
PAST PRESIDENT
8332 SW SHENANDOAH WAY
TUALATIN OR 97062

Officer/Director/Trustee Four

CHELCIE KOLASKI
SECRETARY
1044 11TH AVE
LONGVIEW WA 98632

Officer/Director/Trustee Five

LISA WESTLUND
OPERATIONS MANAGER
41410 NE GERBER MCKEE RD
AMBOY WA 98601

Organization’s website WWW.ADDICTIONCEU.ORG
Organization’s email CDTC@ADDICTIONCEU.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/27/2009
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F20 - Alcohol, Drug and Substance Abuse, Dependency Prevention and Treatment
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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