FORM 1023-EZ for KIWANIS CLUB OF PROVIDENCE POINT ISSAQUAH FOUNDATION

Field Data
EIN 82-4041995
Case Number EO-2018026-000171
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KIWANIS CLUB OF PROVIDENCE POINT ISSAQUAH FOUNDATION
Organization’s Mailing Address 4135 PROVIDENCE POINT DRIVE
City ISSAQUAH
State WA
ZIP 98029
Accounting period End 12
Primary contact name KATHLEEN HUCKABAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JANIS HONG
PRESIDENT
4081 224TH LANE SE 307
ISSAQUAH WA 98029

Officer/Director/Trustee Two

JUDITH WING
PRESIDENT ELECT
22133 SE 40TH LANE
ISSAQUAH WA 98029

Officer/Director/Trustee Three

JOHN GOROW
SECRETARY
22563 SE 42ND TERRACE
ISSAQUAH WA 98029

Officer/Director/Trustee Four

TED GAMELIN
TREASURER
4117 221ST PLACE SE
ISSAQUAH WA 98029

Officer/Director/Trustee Five

DON CUMMINGS
BOARD MEMBER
22707 SE 43RD CT
ISSAQUAH WA 98029

Organization’s website HTTP://PROVIDENCEPOINTKIWANIS.ORG/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/20/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
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 JOHN GOROW
Signature Title SECRETARY
Signature Date 1/23/18

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