FORM 1023-EZ for THE HUMAN LIBRARY INITIATIVE

Field Data
EIN 86-2261203
Case Number EO-2021116-000659
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE HUMAN LIBRARY INITIATIVE
Organization’s Mailing Address 19117 RICHMOND BEACH DRIVE NW
City SHORELINE
State WA
ZIP 98177
Accounting period End 12
Primary contact name JANE PRYJMAK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANGELIQUE LADOUX
PRESIDENT AND DIRECTOR
19117 RICHMOND BEACH DRIVE NW
SHORELINE WA 98177

Officer/Director/Trustee Two

TERI BOWDLE
SEC TREAS AND DIRECTOR
19117 RICHMOND BEACH DRIVE NW
SHORELINE WA 98177

Officer/Director/Trustee Three

LISA NELSON
DIRECTOR
19117 RICHMOND BEACH DRIVE NW
SHORELINE WA 98177

Officer/Director/Trustee Four

RICHARD STEVENSON
EXECUTIVE DIRECTOR
19117 RICHMOND BEACH DRIVE NW
SHORELINE WA 98177

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/22/2021
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B90 - Educational Services and Schools - Other
Organization’s purpose Charitable: Yes
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 Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name RICHARD STEVENSON
Signature Title EXECUTIVE DIRECTOR
Signature Date 4/23/2021

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