FORM 1023-EZ for AGAPE ROAD EMMAUS CHRYSALIS COMMUNITY CORPPRATION

Field Data
EIN 84-2311620
Case Number EO-2019191-000347
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AGAPE ROAD EMMAUS CHRYSALIS COMMUNITY CORPPRATION
Organization’s Mailing Address 100 CIRCLE DRIVE
City HORSE CAVE
State KY
ZIP 42749
Accounting period End 12
Primary contact name LARRY C HOWLETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PHILLIP TRENT
PRESIDENT
100 CIRCLE DRIVE
HORSE CAVE KY 42749

Officer/Director/Trustee Two

CHUCK GIBSON
DIRECTOR
5002 BEECHWOOD DRIVE
SOMERSET KY 42501

Officer/Director/Trustee Three

HAROLD PARRIGIN
DIRECTOR
1035 JUNIOR BEATY ROAD
PALL MALL TN 38577

Officer/Director/Trustee Four

ANDREA GIBSON
DIRECTOR
5002 BEECHWOOD
SOMERSET KY 42501

Officer/Director/Trustee Five

JASON ENGLAND
DIRECTOR
125 J HARPER ROAD
HORSE CAVE KY 42749

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/12/12
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
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 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 PHILLIP TRENT
Signature Title PRESIDENT
Signature Date 7/8/19

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