FORM 1023-EZ for QUEEN CREEK MEETING HOUSE

Field Data
EIN 61-1738270
Case Number EO-2014256-000083
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name QUEEN CREEK MEETING HOUSE
Organization’s Mailing Address 19729 EAST SAN TAN BLVD
City QUEEN CREEK
State AZ
ZIP 85142-7068
Accounting period End 12
Primary contact name DANA NANCE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DANA H NANCE
PRESIDENT
3883 E FLINTLOCK DR
QUEEN CREEK AZ 85142-8724

Officer/Director/Trustee Two

ROGER P ROSE
VICE PRESIDENT
19419 E CALLE DE FLORES
QUEEN CREEK AZ 85142-9301

Officer/Director/Trustee Three

MARYANN A NANCE
TREASURER
3883 E FLINTLOCK
QUEEN CREEK AZ 85142-8724

Officer/Director/Trustee Four

CHARLES C KEETON
MEMBER AT LARGE
20368 E AVENIDA DEL VALLE
QUEEN CREEK AZ 85142-1234

Officer/Director/Trustee Five

CHARLES I SIMOES
SECRETARY
4818 E SHAPINSAY DR
SAN TAN VALLEY AZ 85140-5043

Organization’s website QUEENCREEKMEETINGHOUSE.COM
Organization’s email INFO@QUEENCREEKMEETINGHOUSE.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/9/2014
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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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