FORM 1023-EZ for ST ANDREWS COMMUNITY LIFE CENTER INC DBA SACLC INC

Field Data
EIN 47-1647090
Case Number EO-2015247-000192
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ST ANDREWS COMMUNITY LIFE CENTER INC DBA SACLC INC
Organization’s Mailing Address 522 MISSOURI AVE
City FT WORTH
State TX
ZIP 76104
Accounting period End 12
Primary contact name FITZGERALD MURRAINE ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DOROTHY DU BOISE
PRESIDENT
522 MISSOURI AVE
FORT WORTH TX 76104

Officer/Director/Trustee Two

MICHAEL CASEY
VICE PRESIDENT
P O BOX 2577
ARLINGTON TX 76004

Officer/Director/Trustee Three

CYRUS ALEXANDER
SECRETARY
2508 PIONEER DR
FORTH WORTH TX 76119

Officer/Director/Trustee Four

DAISY MAE DU BOISE
TREASURER
4901 WINESANKER WAY
FORTH WORTH TX 76133

Officer/Director/Trustee Five

FITZGERALD MURRAINE
INTREM EXECUTIVE DIRECTOR
5609 OAK BROOK RD
ARLINGTON TX 76016

Organization’s website TBA
Organization’s email FITZMURRAINE@AOL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/21/2014
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
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 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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