FORM 1023-EZ for THE BLUE COLLAR WELLNESS PROJECT

Field Data
EIN 84-3662732
Case Number EO-2019343-000546
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE BLUE COLLAR WELLNESS PROJECT
Organization’s Mailing Address 8827 31ST AVE
City SEATTLE
State WA
ZIP 98126
Accounting period End 12
Primary contact name JOLEEN BLACK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOLEEN BLACK
DIRECTOR/PRESIDENT
8827 31ST AVE
SEATTLE WA 98126

Officer/Director/Trustee Two

KELLY O BRIEN
SECRETARY
8827 31ST AVE
SEATTLE WA 98126

Officer/Director/Trustee Three

STEFAN BLACK
TREASURER
8827 31ST AVE
SEATTLE WA 98126

Officer/Director/Trustee Four

MEGAN HOSKINSON
DIRECTOR
8827 31ST AVE
SEATTLE WA 98126

Officer/Director/Trustee Five

JENNIFER HANES
DIRECTOR
8827 31ST AVE
SEATTLE WA 98126

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/19/2019
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion 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 JOLEEN BLACK
Signature Title DIRECTOR/PRESIDENT
Signature Date 12/6/2019

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