FORM 1023-EZ for GOLD STAR PARENTS RETREAT

Field Data
EIN 81-3988230
Case Number EO-2016336-000295
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GOLD STAR PARENTS RETREAT
Organization’s Mailing Address 2620 TAR HEEL DR
City FORT WORTH
State TX
ZIP 76123-1648
Accounting period End 12
Primary contact name TERRY A BURGESS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TERRY BURGESS
PRESIDENT
2620 TAR HEEL DR
FORT WORTH TX 76123-1648

Officer/Director/Trustee Two

ELISABETH BURGESS
VICE PRESIDENT
2620 TAR HEEL DR
FORT WORTH TX 76123-1648

Officer/Director/Trustee Three

SARA OVERAL
EXECUTIVE DIRECTOR
1920 GRASSMERE LN APT 2036
MCKINNEY TX 75071-8549

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/8/2016
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
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 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 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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