FORM 1023-EZ for CONSCIOUS CAPITALISM SEATTLE

Field Data
EIN 81-2102505
Case Number EO-2016102-000093
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CONSCIOUS CAPITALISM SEATTLE
Organization’s Mailing Address 220 SECOND AVENUE SOUTH - SUITE 202
City SEATTLE
State WA
ZIP 98104
Accounting period End 12
Primary contact name FRED WHITTLESEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JENNIFER MARTIN
CHAIRPERSON
1922 42ND AVENUE EAST SUITE 18
SEATTLE WA 98112

Officer/Director/Trustee Two

FRED WHITTLESEY
TREASURER
220 2ND AVENUE SOUTH SUITE 202
SEATTLE WA 98104

Officer/Director/Trustee Three

HANS BJORDAHL
DIRECTOR
600 NORTH 36TH STREET SUITE 200
SEATTLE WA 98103

Officer/Director/Trustee Four

BOBBY BAKSHI
DIRECTOR
16904 JUANITA DRIVE
KENMORE WA 98028

Officer/Director/Trustee Five

PAUL LANDRAITIS
DIRECTOR
3008 NE 201ST PLACE
LAKE FOREST PARK WA 98155

Organization’s website WWW.CONSCIOUSCAPITALISMSEATTLE.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/5/2016
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y03 - Professional Societies, Associations
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
Signature Title
Signature Date

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