FORM 1023-EZ for NORTHWEST BROTHERHOOD FOUNDATION OFWASHINGTON

Field Data
EIN 82-3280469
Case Number EO-2017334-000206
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NORTHWEST BROTHERHOOD FOUNDATION OFWASHINGTON
Organization’s Mailing Address PO BOX 477
City TENINO
State WA
ZIP 98589
Accounting period End 12
Primary contact name ROGER MOORE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROGER MOORE
PRESIDENT
3030 LOWERY LN
CENTRALIA WA 98531

Officer/Director/Trustee Two

BENJAMIN WILBURN
DIRECTOR
318 WICHMAN ST S
TENINO WA 98589

Officer/Director/Trustee Three

JOSEPH RICHEY
VICE PRESIDENT
18920 MELON ST SW
ROCHESTER WA 98579

Officer/Director/Trustee Four

KATIE MOORE
SECRETARY / TREASURER
3030 LOWERY LN
CENTRALIA WA 98531

Organization’s website WWW.NWBROTHERHOOD.ORG
Organization’s email INFO@NWBROTHERHOOD.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/28/2017
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T30 - Public Foundations
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 Yes
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 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
Signature Title
Signature Date

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