FORM 1023-EZ for EXPERIENCE GOD NORTHWEST

Field Data
EIN 81-3884321
Case Number EO-2017163-000188
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EXPERIENCE GOD NORTHWEST
Organization’s Mailing Address 16420 SE MCGILLIVRAY SUITE 103
City VANCOUVER
State WA
ZIP 98683
Accounting period End 12
Primary contact name BRIAN LIVINGSTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRIAN LIVINGSTON
DIRECTOR
20817 NE 159TH ST
BRUSH PRAIRIE WA 98606

Officer/Director/Trustee Two

CAROL LIVINGSTON
DIRECTOR
20817 NE 159TH ST
BRUSH PRAIRIE WA 98606

Officer/Director/Trustee Three

JAMES OWENS
DIRECTOR
37 W 30TH AVE
SPOKANE WA 99203

Organization’s website WWW.EXPGOD.COM
Organization’s email BRIAN@EXPGOD.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/13/2016
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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 Yes
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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