FORM 1023-EZ for CAGAYAN VALLEY ASSOCIATION

Field Data
EIN 27-2522135
Case Number EO-2016229-000393
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CAGAYAN VALLEY ASSOCIATION
Organization’s Mailing Address 10138 BRIDGEPORT WAY SW
City LAKEWOOD
State WA
ZIP 98499
Accounting period End 12
Primary contact name MARIE GEMMELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WALDO DAGAN
PRESIDENT
1420 MAIN ST
SUMNER WA 98390

Officer/Director/Trustee Two

CONSUELO EPISTOLA
VICE PRESIDENT
10423 SE 214TH PL
KENT WA 98031

Officer/Director/Trustee Three

IRENE BUENAVISTA
SECRETARY
38042 39TH AVE S
AUBURN WA 98001

Officer/Director/Trustee Four

MARIE GEMMELL
TREASURER
6601 E MCKINLEY AVE
TACOMA WA 98404

Officer/Director/Trustee Five

MARGARITA MOLINA
EXECUTIVE DIRECTOR
20408 14TH DR SE
BOTHELL WA 98012

Organization’s website WWW.CAGAYANVALLEYASSOCIATION.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/28/2010
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P84 - Ethnic, Immigrant Centers, Services
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
Signature Title
Signature Date

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