FORM 1023-EZ for COMMUNITY IMPACT CLUB INC
| Field | Data |
|---|---|
| EIN | 84-3449086 |
| Case Number | EO-2019347-000245 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | COMMUNITY IMPACT CLUB INC |
| Organization’s Mailing Address | 2205 MESSINA COURT |
| City | ELDERSBURG |
| State | MD |
| ZIP | 21784 |
| Accounting period End | 12 |
| Primary contact name | KIRSTEN MATTHIESEN |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
KIRSTEN MATTHIESEN
PRESIDENT
2205 MESSINA COURT
ELDERSBURG MD 21784
Officer/Director/Trustee Two
MICHELE GEIDEL
VICE PRESIDENT
6408 GLASGOW CIRCLE
ELDERSBURG MD 21784
Officer/Director/Trustee Three
STACY ELLIS
SECRETARY
1900 SHUB FARM ROAD
MARRIOTTSVILLE MD 21104
Officer/Director/Trustee Four
TODD MATTHIESEN
TREASURER
2205 MESSINA COURT
ELDERSBURG MD 21784
Officer/Director/Trustee Five
KAREN BROGAN
OFFICER
617 TANGLEWOOD DRIVE
ELDERSBURG MD 21784
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/22/2019 |
| Organization Incorporation State | MD |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | W12 - Fund Raising and/or Fund Distribution |
| 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 | 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 | No |
| Benefit of College | No |
| Private Foundation 508(e) | Yes |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | KIRSTEN MATTHIESEN |
| Signature Title | PRESIDENT |
| Signature Date | 12/11/2019 |
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