FORM 1023-EZ for 55 HOUSE CHURCH

Field Data
EIN 82-3064958
Case Number EO-2018061-000146
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name 55 HOUSE CHURCH
Organization’s Mailing Address 644 W EVANSTON RD
City TIPP CITY
State OH
ZIP 45371
Accounting period End 12
Primary contact name PETE TRICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PETE TRICK
HOUSE SHEPARD
644 W EVANSTON RD
TIPP CITY OH 45371-2054

Officer/Director/Trustee Two

SCOTT SCROZZARI
ASSISTANT HOUSE SHEPARD
480 BIRCHWOOD CT
TROY OH 45373-4357

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/12/17
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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 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 PETE TRICK
Signature Title HOUSE SHEPARD
Signature Date 2/28/18

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