FORM 1023-EZ for SURF AND SERVE

Field Data
EIN 47-4898900
Case Number EO-2016083-000453
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SURF AND SERVE
Organization’s Mailing Address 482 CONCORD PLACE
City WYCKOFF
State NJ
ZIP 07481
Accounting period End 12
Primary contact name CAMERON GILMORE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CAMERON GILMORE
EXECUTIVE DIRECTOR
482 CONCORD PLACE
WYCKOFF PA 07481

Officer/Director/Trustee Two

TODD DAVIS
CHIEF FINANCIAL OFFICER
832 HELEN AVENUE
LANCASTER PA 17601

Officer/Director/Trustee Three

PAUL VAN WINKLE
DIRECTOR OF OPERATIONS
409 GATEPOST CT
PURCELLVILLE VA 20132

Officer/Director/Trustee Four

DAN COTTON
OFFICER
1017 FIRST AVE
ASBURY PARK NJ 07712

Officer/Director/Trustee Five

CHRIS GILMORE
OFFICER
29 CLIFFORD DRIVE
WAYNE NJ 07470

Organization’s website SURFANDSERVEMISSIONS.ORG
Organization’s email SURFANDSERVE.CO@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/29/2015
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X99 - Religion Related, Spiritual Development N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers Yes
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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
Signature Title
Signature Date

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