FORM 1023-EZ for CHURCH IN ACTION

Field Data
EIN 30-0867714
Case Number EO-2015174-000284
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHURCH IN ACTION
Organization’s Mailing Address 10232 EMPRESS BLVD
City TUSCALOOSA
State AL
ZIP 35405-7412
Accounting period End 12
Primary contact name WADE LEWIS SR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

WADE LEWIS SR
PRESIDENT, VICE PRESIDENT, DIRECTOR
10232 EMPRESS BLVD
TUSCALOOSA AL 35405-7412

Officer/Director/Trustee Two

LAURICE MCCOLLUM
TRESASURER, DIRECTOR
1601 MIMOSA PARK RD APT 166
TUSCALOOSA AL 35405

Officer/Director/Trustee Three

NICOLE HARRINGTON
SECRETARY, DIRECTOR
PO BOX 72375
TUSCALOOSA AL 35407

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/23/2015
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 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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