FORM 1023-EZ for CRPS CLUBHOUSE

Field Data
EIN 46-5370538
Case Number EO-2014349-000314
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CRPS CLUBHOUSE
Organization’s Mailing Address 5513 CRANBROOK WAY
City FAIR OAKS
State CA
ZIP 95628
Accounting period End 9
Primary contact name MARLEICE HYDE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARLEICE HYDE
EXECUTIVE DIRECTOR
3268 GROVELAND WAY
ANTELOPE CA 95843

Officer/Director/Trustee Two

DAWN RODRIGUEZ
DIRECTOR/HOUSE MANAGER
5513 CRANBROOK WAY
FAIR OAKS CA 95628

Officer/Director/Trustee Three

CINDY IVEY
TREASURER/SECRETARY
3632 HALLELUJAH COURT NO 1
CARMICHAEL CA 95608

Officer/Director/Trustee Four

TINA MYERS
DIRECTOR/PR
PO BOX 1215
KENAI AK 99611

Officer/Director/Trustee Five

MAIA LAMPKIN
DIRECTOR/FUNDRAISING
3840 SAMOS WAY
SACRAMENTO CA 95823

Organization’s website WWW.CRPSCLUBHOUSE.ORG
Organization’s email CRPS.RSD.CLUBHOUSE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/10/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L40 - Low-Cost Temporary Housing
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 Yes
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 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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