FORM 1023-EZ for BROCK ELLIOTT PTO

Field Data
EIN 47-3593645
Case Number EO-2016020-000069
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BROCK ELLIOTT PTO
Organization’s Mailing Address 1110 STONUM LANE
City MANTECA
State CA
ZIP 95337-6740
Accounting period End 12
Primary contact name LUCY ARREDONDO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LUCY ARREDONDO
PRESIDENT
1809 WINDING RIVER
MANTECA CA 95337-8249

Officer/Director/Trustee Two

KIMBERLY GASTON
VICE PRESIDENT
1682 DANIELS STREET
MANTECA CA 95337-6743

Officer/Director/Trustee Three

ALONDA SCHOCK
TREASURER
1045 HATCHCOVER PLACE
MANTECA CA 95337-6703

Officer/Director/Trustee Four

MICHELE CERVANTES
SECRETARY
1764 DANIELS
MANTECA CA 95337-8324

Organization’s website
Organization’s email BROCKELLIOTTPTO@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/6/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B94 - Parent/Teacher Group
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 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
Signature Title
Signature Date

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