FORM 1023-EZ for BLACK OAK MINISTRIES

Field Data
EIN 82-2073483
Case Number EO-2017191-000209
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLACK OAK MINISTRIES
Organization’s Mailing Address 920 SKYLINE DRIVE
City HARRIMAN
State TN
ZIP 37748
Accounting period End 12
Primary contact name JAMIE GYOLAI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMIE GYOLAI
PRESIDENT
920 SKYLINE DRIVE
HARRIMAN TN 37748

Officer/Director/Trustee Two

BEVERLY OCHS
VICE PRESIDENT
922 SKYLINE DRIVE
HARRIMAN TN 37748

Officer/Director/Trustee Three

TIM OCHS
TREASURER
922 SKYLINE DRIVE
HARRIMAN TN 37748

Officer/Director/Trustee Four

SARAH GYOLAI
SECRETARY
920 SKYLINE DRVIE
HARRIMAN TN 37748

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/13/2017
Organization Incorporation State IA
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 No
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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
Signature Title
Signature Date

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