FORM 1023-EZ for COACHES AGAINST CANCER

Field Data
EIN 81-1206303
Case Number EO-2016039-000039
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COACHES AGAINST CANCER
Organization’s Mailing Address 2500 ARROWHEAD LANE
City LIBERAL
State KS
ZIP 67901
Accounting period End 12
Primary contact name THOMAS E POLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

OSCAR RODRIGUEZ
EXECUTIVE DIRECTOR
1950 3RD STREET
LA VERNE CA 91750

Officer/Director/Trustee Two

SARAH KNUDSEN
PRESIDENT
501 LILAC DRIVE
LIBERAL KS 67901

Officer/Director/Trustee Three

ARMANDO ZAPIEN
VICE PRESIDENT
803 ELM STREET
LIBERAL KS 67901

Officer/Director/Trustee Four

THOMAS POLEY
SECRETARY/TREASURER
2500 ARROWHEAD LANE
LIBERAL KS 67901

Officer/Director/Trustee Five

MIRTA RODRIGUEZ
MEMBER
1109 CROSS GATE
MANHATTAN KS 66503

Organization’s website
Organization’s email ED.POLEY@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2016
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G30 - Cancer
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 No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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