FORM 1023-EZ for POLK CITY COMMUNITY OUTREACH PROGRAM CORP

Field Data
EIN 65-1048781
Case Number EO-2015341-000304
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name POLK CITY COMMUNITY OUTREACH PROGRAM CORP
Organization’s Mailing Address 424 SMITH ROAD
City POLK CITY
State FL
ZIP 33868
Accounting period End 12
Primary contact name CALPURTIA L MCGILL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CALPURTIA L MCGILL
PRESIDENT
505 CALLA PLACE
POLK CITY FL 33868

Officer/Director/Trustee Two

LEROY LISBON
DIRECTOR
903 S CHARMIL AVENUE
LAKE ALFRED FL 33850

Officer/Director/Trustee Three

CHARLES MCGILL
DIRECTOR
505 CALLA PLACE
POLK CITY FL 33868

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/17/2000
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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