FORM 1023-EZ for CRUCIBLE PREPARATORY

Field Data
EIN 84-2859752
Case Number EO-2019241-000370
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CRUCIBLE PREPARATORY
Organization’s Mailing Address 1916 MONTVIEW DRIVE
City GREELEY
State CO
ZIP 80631
Accounting period End 12
Primary contact name ROBERT MAXEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT MAXEY
PRESIDENT
1916 MONTVIEW DR
GREELEY CO 80631

Officer/Director/Trustee Two

TSIKY MINOHASINA RANDRIAMANANTENA
VICE PRESIDENT
1916 MONTVIEW DR
GREELEY CO 80631

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/26/19
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B90 - Educational Services and Schools - Other
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 Yes
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 ROBERT MAXEY
Signature Title PRESIDENT
Signature Date 8/27/19

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