FORM 1023-EZ for GENESIS PROCLAIMED ASSOC

Field Data
EIN 56-2301047
Case Number EO-2016278-000124
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GENESIS PROCLAIMED ASSOC
Organization’s Mailing Address PO BOX 2245
City CENTREVILLE
State VA
ZIP 20122-2245
Accounting period End 12
Primary contact name DICK FISCHER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DICK FISCHER
PRESIDENT
9217 CYNTHIA ST
MANASSAS PARK VA 20111-3021

Officer/Director/Trustee Two

DONALD PERRETT
VICE PRESIDENT
225 CENTURY PL APT 2111
ALEXANDRIA VA 22304-5777

Officer/Director/Trustee Three

MICHELLE FISCHER
SECRETARY
10616 NORMAN AVE
FAIRFAX VA 22030-2925

Organization’s website WWW.GENESISPROCLAIMED.ORG
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/7/2002
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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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