FORM 1023-EZ for CHILDREN OF CHRIST HOME INC

Field Data
EIN 47-5030401
Case Number EO-2015268-000228
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHILDREN OF CHRIST HOME INC
Organization’s Mailing Address PO BOX 30257
City PENSACOLA
State FL
ZIP 32503
Accounting period End 12
Primary contact name ELIZABETH MRACHEK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

AL STUBBLEFIELD
PRESIDENT
4691 BOHEMIA PLACE
PENSACOLA FL 32504

Officer/Director/Trustee Two

LORI KIZZIAH
VICE PRESIDENT
6551 CHARDONNAY
PENSACOLA FL 32504

Officer/Director/Trustee Three

KIRSTEN WERT
SECRETARY
3305 PITCHER PLANT CIRCLE
PENSACOLA FL 32506

Officer/Director/Trustee Four

TERRY DAVIS
TREASURER
3775 PINE FOREST RD
CANTONMENT FL 32533

Officer/Director/Trustee Five

ELIZABETH MRACHEK
CHIEF FINANCIAL OFFICER
2485 TRONJO CIR
PENSACOLA FL 32503

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/24/2014
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
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 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 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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