FORM 1023-EZ for PERMACULTURE LIFESTYLE INSTITUTE

Field Data
EIN 47-4721649
Case Number EO-2016062-000113
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PERMACULTURE LIFESTYLE INSTITUTE
Organization’s Mailing Address 1423 EAST 29TH
City TACOMA
State WA
ZIP 98404
Accounting period End 11
Primary contact name ULYSSES A MARTIN III
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ULYSSES MARTIN III
DIRECTOR
5923 45TH AVENUE CT E
TACOMA WA 98443

Officer/Director/Trustee Two

JOHN WESLEY III
DIRECTOR
517 S 90TH ST
TACOMA WA 98444

Officer/Director/Trustee Three

ELLIS HOLIFIELD
DIRECTOR
4521 S 7TH ST
TACOMA WA 98409

Officer/Director/Trustee Four

DUANE MAHONE
DIRECTOR
136 E 62ND ST
TACOMA WA 98404

Organization’s website WWW.PERMACULTURELIFESTYLEINSTITUTE.ORG
Organization’s email ULYSSES@PERMACULTURELIFESTYLEINSTITUTE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/19/2015
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C99 - Environmental Quality, Protection, and Beautification N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers Yes
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
Signature Title
Signature Date

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