FORM 1023-EZ for CLEARLAKE POLICE OFFICERS ASSOCIATION

Field Data
EIN 76-0708774
Case Number EO-2018141-000320
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CLEARLAKE POLICE OFFICERS ASSOCIATION
Organization’s Mailing Address 14050 OLYMPIC DRIVE
City CLEARLAKE
State CA
ZIP 95422
Accounting period End 12
Primary contact name MARLENE WENTZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RYAN PETERSON
PRESIDENT
14050 OLYMPIC DRIVE
CLEARLAKE CA 95422

Officer/Director/Trustee Two

MARK HARDEN
VICE-PRESIDENT
14050 OLYMPIC DRIVE
CLEARLAKE CA 95422

Officer/Director/Trustee Three

LEONARDO FLORES
SARGEANT AT ARMS
14050 OLYMPIC DRIVE
CLEARLAKE CA 95422

Officer/Director/Trustee Four

MELISSA CARPENTER
TREASURER
14050 OLYMPIC DRIVE
CLEARLAKE CA 95422

Officer/Director/Trustee Five

NICKI BURRELL
SECRETARY
14050 OLYMPIC DRIVE
CLEARLAKE CA 95422

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/10
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M99 - Public Safety, Disaster Preparedness, and Relief N.E.C.
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 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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name RYAN PETERSON
Signature Title PRESIDENT
Signature Date 5/17/18

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