FORM 1023-EZ for CITIZENS4COMMUNITY INC

Field Data
EIN 81-1022094
Case Number EO-2016251-000153
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CITIZENS4COMMUNITY INC
Organization’s Mailing Address PO BOX 2193
City SISTERS
State OR
ZIP 97759-1958
Accounting period End 12
Primary contact name ROBYN C HOLDMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBYN HOLDMAN
PRESIDENT
14402 CROSSROADS LOOP
SISTERS OR 97759-1958

Officer/Director/Trustee Two

KENT NEFF
SECRETARY
871 SOUTH NEW MOON COURT
SISTERS OR 97759-1958

Officer/Director/Trustee Three

BRUCE ROGNLIEN
TREASURER
16173 HWY 126
SISTERS OR 97759-1958

Organization’s website WWW.CITIZENS4COMMUNITY.COM
Organization’s email CITIZENS4COMMUNITY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/6/2016
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S99 - Community Improvement, Capacity Building N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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
Signature Title
Signature Date

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