FORM 1023-EZ for COMMUNITY BRIDGES NORTHWEST

Field Data
EIN 83-1094666
Case Number EO-2018297-000333
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COMMUNITY BRIDGES NORTHWEST
Organization’s Mailing Address 18419 79TH PL W
City LYNNWOOD
State WA
ZIP 98036
Accounting period End 12
Primary contact name TIFFANY GONZALEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIFFANY GONZALEZ
CEO
18419 79TH PL W
EDMONDS WA 98026

Officer/Director/Trustee Two

COURTNEY JOHNSON
DIRECTOR
21515 86TH AVE W
EDMONDS WA 98026

Officer/Director/Trustee Three

ERIN ANNE DUNDAS
DIRECTOR
19705 88TH AVE W
EDMONDS WA 98026

Officer/Director/Trustee Four

BARBARA BULEY
DIRECTOR
18419 79TH PL W
EDMONDS WA 98026

Officer/Director/Trustee Five

NATHAN GONZALEZ
DIRECTOR
18419 79TH PL W
EDMONDS WA 98026

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 TIFFANY GONZALEZ
Signature Title CEO
Signature Date 10/22/18

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