FORM 1023-EZ for CALVARY CEMETERY ASSOCIATION

Field Data
EIN 27-1119563
Case Number EO-2015002-000209
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CALVARY CEMETERY ASSOCIATION
Organization’s Mailing Address 1495 SMITH COUNTY ROAD 64
City MIZE
State MS
ZIP 39116
Accounting period End 12
Primary contact name MARY C SLOCUM CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DAVID BURRISS
PRESIDENT
230 SCR 59
MIZE MS 39116

Officer/Director/Trustee Two

HOWARD AUSTIN
DIRECTOR
463 SCR 58
MIZE MS 39116

Officer/Director/Trustee Three

DICK LACK
DIRECTOR
601 SCR 64A
MIZE MS 39116

Officer/Director/Trustee Four

DELORES SMITH
SECRETARY
1495 SCR 64
MIZE MS 39116

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/8/1973
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y50 - Cemeteries, Burial Services
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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