FORM 1023-EZ for CROSSROADS COMMUNITY OUTREACH

Field Data
EIN 81-4791709
Case Number EO-2016365-000283
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CROSSROADS COMMUNITY OUTREACH
Organization’s Mailing Address 1937 MAPLE AVE
City FLORENCE
State AL
ZIP 35630
Accounting period End 12
Primary contact name KIMBERLY JACKSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIMBERLY JACKSON
PRESIDENT, DIRECTOR
1937 MAPLE AVE
FLORENCE AL 35630

Officer/Director/Trustee Two

ROSE WIGGINS
SECRETARY, DIRECTOR
1315 N MONTGOMERY AVE
SHEFFIELD AL 35660

Officer/Director/Trustee Three

JOHN WILLIAMS
TREASURER, DIRECTOR
333 LINDENBURG AVE
FLORENCE AL 35630

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/22/2016
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 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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