FORM 1023-EZ for PACIFIC JUDO ACADEMY

Field Data
EIN 91-2032921
Case Number EO-2017305-000321
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PACIFIC JUDO ACADEMY
Organization’s Mailing Address 5505 N LOLO LANE
City SPOKANE
State WA
ZIP 99217
Accounting period End 12
Primary contact name MICHAEL MARCELLA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LEIGH YAMADA
PRESIDENT
PO BOX 600
NINE MILE FALLS WA 99026

Officer/Director/Trustee Two

ISAMU YAMADA
CHAIR
PO BOX 600
NINE MILE FALLS WA 99026

Officer/Director/Trustee Three

PAUL ZIEGMAN
VICE PRESIDENT
6220 S BEN BURR RD
SPOKANE WA 99223

Officer/Director/Trustee Four

MICHAEL MARCELLA
TREASURER
5505 N LOLO LANE
SPOKANE WA 99217

Officer/Director/Trustee Five

JOY RODRIGUEZ
SECRETARY
2407 S ADAMS
SPOKANE WA 99203

Organization’s website WWW.PACIFICJUDOACADEMY.ORG
Organization’s email PACIFICJUDOACADEMY@COMCAST.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/12/2007
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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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