FORM 1023-EZ for TICA NW REGION

Field Data
EIN 35-2683893
Case Number EO-2020076-000288
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TICA NW REGION
Organization’s Mailing Address 5517 152ND ST SW
City EDMONDS
State WA
ZIP 98026-4343
Accounting period End 4
Primary contact name ELAINE HAWKSWORTH-WEITZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ELAINE HAWKSWORTH-WEITZ
REGIONAL DIRECTOR
5517 152ND ST SW
EDMONDS WA 98026-4343

Officer/Director/Trustee Two

TRACY HISEL
SECRETARY
549 STATE ROUTE
TOLEDO WA 98591-9719

Officer/Director/Trustee Three

KAREN FLETCHER
TREASURER
115 HARRINGTON RD
COUPEVILLE WA 98239-1143

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/2/2020
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
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 ELAINE HAWKSWORTH-WEITZ
Signature Title REGIONAL DIRECTOR
Signature Date 3/12/2020

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