FORM 1023-EZ for PROVIDENCE COLLECTIVE

Field Data
EIN 85-2772528
Case Number EO-2021253-000192
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PROVIDENCE COLLECTIVE
Organization’s Mailing Address 11211 MAIN ST
City BELLEVUE
State WA
ZIP 98004-6405
Accounting period End 12
Primary contact name JONATHAN STEVENS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRISTINE SOUL
CHIEF EXECUTIVE OFFICER
11211 MAIN ST
BELLEVUE WA 98004-6405

Officer/Director/Trustee Two

JACOLINE STEWART
TREASURER
11211 MAIN ST
BELLEVUE WA 98004-6405

Officer/Director/Trustee Three

LISA BAILEY
SECRETARY
11211 MAIN ST
BELLEVUE WA 98004-6405

Officer/Director/Trustee Four

SOPHALLY SHOWALTER
DIRECTOR
11211 MAIN ST
BELLEVUE WA 98004-6405

Organization’s website NA
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/21/2020
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J99 - Employment, Job Related N.E.C.
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 SOPHALLY SHOWALTER
Signature Title DIRECTOR
Signature Date 9/8/2021

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