FORM 1023-EZ for LOCAL CONNECTIVITY LAB

Field Data
EIN 84-3559695
Case Number EO-2019310-000100
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LOCAL CONNECTIVITY LAB
Organization’s Mailing Address 3800 E STEVENS WAY NE RM 384
City SEATTLE
State WA
ZIP 98195-2355
Accounting period End 9
Primary contact name ESTHER JANG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ESTHER JANG
DIRECTOR
5532 39TH AVE NE
SEATTLE WA 98105-2211

Officer/Director/Trustee Two

KURTIS HEIMERL
DIRECTOR
3641 BAGLEY AVE N
SEATTLE WA 98103-9132

Officer/Director/Trustee Three

SPENCER SEVILLA
DIRECTOR
4434 S HOLLY ST
SEATTLE WA 98118-3326

Officer/Director/Trustee Four

MATTHEW JOHNSON
DIRECTOR
4550 51ST AVE NE
SEATTLE WA 98105-3831

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/1/19
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code U40 - Engineering and Technology Research, Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 ESTHER JANG
Signature Title DIRECTOR
Signature Date 11/3/19

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