FORM 1023-EZ for CROSSROADS OUTREACH FOUNDATION

Field Data
EIN 81-2601046
Case Number EO-2016139-000398
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CROSSROADS OUTREACH FOUNDATION
Organization’s Mailing Address 22246 LYONS VALLEY RD
City ALPINE
State CA
ZIP 91901
Accounting period End 12
Primary contact name CHERYL SAMPO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHERYL SAMPO
PRESIDENT, DIRECTOR
22246 LYONS VALLEY RD
ALPINE CA 91901

Officer/Director/Trustee Two

MEAGAN DAVIS
SECRETARY, DIRECTOR
10160 CASA DE ORO BLVD
SPRING VALLEY CA 91977

Officer/Director/Trustee Three

DAVID DIGIORGIO
TREASURER, DIRECTOR
22246 LYONS VALLEY RD
ALPINE CA 91901

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/19/2016
Organization Incorporation State CA
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: Yes
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
Signature Title
Signature Date

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