FORM 1023-EZ for CRYSTAL LAKES COMMUNITY FOUNDATION

Field Data
EIN 83-2574954
Case Number EO-2019072-000493
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CRYSTAL LAKES COMMUNITY FOUNDATION
Organization’s Mailing Address 6310 RAVENA RD
City PLEASANT VALLEY
State MO
ZIP 64068
Accounting period End 6
Primary contact name JON MORRIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SANDRA HAWN
CHAIRPERSON
6310 RAVENA RD
PLEASANT VALLEY MO 64068

Officer/Director/Trustee Two

JON MORRIS
TREASURER
15269 LAKE SHORE DR
CRYSTAL LAKES MO 64024

Officer/Director/Trustee Three

RHONDA SHEA
SECRETARY
15159 HWY Y
CRYSTAL LAKES MO 64024

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/19/18
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
Organization’s purpose Charitable: Yes
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 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 JON MORRIS
Signature Title TREASURER
Signature Date 3/11/19

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