FORM 1023-EZ for CLAVIS DAVID CGS INC

Field Data
EIN 87-2358134
Case Number EO-2021250-000551
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CLAVIS DAVID CGS INC
Organization’s Mailing Address 1803 W UNIVERSITY AVE
City WICHITA
State KS
ZIP 67213
Accounting period End 6
Primary contact name MATTHEW DAUGHERTY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEITH CARLIN
PRESIDENT
13607 HARDTNER ST
WICHITA KS 67235

Officer/Director/Trustee Two

MATTHEW DAUGHERTY
TREASURER
12802 W 21ST ST N
WICHITA KS 67235

Officer/Director/Trustee Three

ANN CARLIN
SECRETARY
13607 HARDTNER ST
WICHITA KS 67235

Officer/Director/Trustee Four

MARY BETH GONZALEZ
LEAD CATECHIST
542 N MARK ALLEN ST
WICHITA KS 67212

Officer/Director/Trustee Five

DENISE DAUGHERTY
2ND LEAD CATECHIST
12802 W 21ST ST N
WICHITA KS 67235

Organization’s website
Organization’s email CLAVISDAVIDCGS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/23/2021
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X22 - Roman Catholic
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 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 MATTHEW DAUGHERTY
Signature Title TREASURER
Signature Date 9/3/2021

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