FORM 1023-EZ for OLYMPIC MOUNTAIN WELLNESS NFP
| Field | Data |
|---|---|
| EIN | 82-4160979 |
| Case Number | EO-2018047-000109 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | OLYMPIC MOUNTAIN WELLNESS NFP |
| Organization’s Mailing Address | PO BOX 821004 |
| City | KENMORE |
| State | WA |
| ZIP | 98028 |
| Accounting period End | 12 |
| Primary contact name | MICHELE MAYATTE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
DOUGLAS LEONARD
PRESIDENT
7231 NE 152ND PL
KENMORE WA 98028
Officer/Director/Trustee Two
MICHELE MAYATTE
DIRECTOR TREASURER AND SECRETARY
7231 NE 152ND PL
KENMORE WA 98028
Officer/Director/Trustee Three
MICHELLE HEMPEL
DIRECTOR
6122 202ND ST SW 103
LYNNWOOD WA 98036
Officer/Director/Trustee Four
ALEXANDER D ROSE
DIRECTOR
2719 48TH AVE SW
SEATTLE WA 98116
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/12/18 |
| Organization Incorporation State | WA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E50 - Rehabilitative Medical 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 | 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 | 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 | DOUGLAS LEONARD |
| Signature Title | PRESIDENT |
| Signature Date | 2/14/18 |
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