FORM 1023-EZ for COMMUNITY VEINS ORGANIZATION

Field Data
EIN 86-3685064
Case Number EO-2021152-000365
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COMMUNITY VEINS ORGANIZATION
Organization’s Mailing Address 4410 LOS ANGELES STREET
City HOUSTON
State TX
ZIP 77026
Accounting period End 12
Primary contact name BRIAN VAUGHN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK WATERS SR
PRESIDENT & DIRECTOR
15386 OLD HOUSTON
CONROE TX 77302

Officer/Director/Trustee Two

BRIAN VAUGHN
TRES & SECT & DIR
4410 LOS ANGELES STREET
HOUSTON TX 77026

Officer/Director/Trustee Three

BILL WALLACE
DIRECTOR & VP
200 SARANAC DRIVE
ELGIN TX 78621

Officer/Director/Trustee Four

KEVIN POLITTE
DIRECTOR
4410 LOS ANGELES STREET
HOUSTON TX 77026

Officer/Director/Trustee Five

MICHAEL COCHRAN
DIRECTOR
848 MITCHELL
ARLINGTON TX 76013

Organization’s website
Organization’s email COMMUNITYVEINSORG@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/21/2021
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: No
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 Yes
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 Yes
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 MARK WATERS SR
Signature Title PRESIDENT & DIRECTOR
Signature Date 5/27/2021

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