FORM 1023-EZ for COMMUNITY CHOICE CREDIT UNION FOUNDATION

Field Data
EIN 47-4414322
Case Number EO-2015306-000423
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COMMUNITY CHOICE CREDIT UNION FOUNDATION
Organization’s Mailing Address 6163 NW 86TH STREET SUITE 105
City JOHNSON
State IA
ZIP 50131
Accounting period End 12
Primary contact name ROGER W REISER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BRIAN FARRELL
DIRECTOR AND PRESIDENT
5454 PONDEROSA DR
WEST DES MOINES IA 50266

Officer/Director/Trustee Two

JOSH COOK
DIRECTOR AND TREASURER
7110 NW 5TH COUT
ANKENY IA 50023

Officer/Director/Trustee Three

ROGER REISER
DIRECTOR AND CHAIRMAN
11645 NW OAKTREE DR
GRIMES IA 50111

Officer/Director/Trustee Four

BRUCE KEMPKES
DIRECTOR AND VICE PRESIDENT
1217 KIOWA AVE
EARLHAM IA 50072

Officer/Director/Trustee Five

KELLEY QUICK
DIRECTOR AND SECRETARY
9208 LONGVIEW DR
JOHNSTON IA 50131

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/3/2015
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
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 Yes
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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