FORM 1023-EZ for CANCER MEMORIAL FUND

Field Data
EIN 94-3476501
Case Number EO-2017075-000368
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CANCER MEMORIAL FUND
Organization’s Mailing Address 29207 333RD AVE SE
City RAVENSDALE
State WA
ZIP 98051
Accounting period End 12
Primary contact name TRISHA ADAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRISHA ADAMS
PRESIDENT
29207 333RD AVE SE
RAVENSDALE WA 98051

Officer/Director/Trustee Two

JEFF TAYLOR
TREASURE
29207 333RD AVE SE
RAVENSDALE WA 98051

Officer/Director/Trustee Three

JOLYN HOHNSTEIN
SECRETARY
PO BOX
AUBURN WA 98022

Organization’s website WWW.CANCERMONUMENT.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/1/2009
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
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 Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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