FORM 1023-EZ for CAMP IMPACT

Field Data
EIN 47-4372273
Case Number EO-2016049-000123
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CAMP IMPACT
Organization’s Mailing Address 2004 HEATHER WAY DRIVE
City ARLINGTON
State TX
ZIP 76012
Accounting period End 12
Primary contact name JANET AARONSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHRISTINE GONZALEZ
PRESIDENT AND DIRECTOR
1035 TWIN BROOKS DRIVE
GRAND PRAIRIE TX 75052

Officer/Director/Trustee Two

BARRY GOLDFARB
TREASURER AND DIRECTOR
1016 LIVE OAK LANE
ARLINGTON TX 76012

Officer/Director/Trustee Three

JANET AARONSON
SECRETARY AND DIRECTOR
1814 WEST CEDAR ELM DRIVE
ARLINGTON TX 76012

Officer/Director/Trustee Four

CINDY FRATINA
VICE PRESIDENT AND DIRECTOR
9701 MEYER FOREST DRIVE APT 12106
HOUSTON TX 77096

Officer/Director/Trustee Five

RACHEL COOPER
DIRECTOR AND CAMP DIRECTOR
2004 HEATHER WAY DRIVE
ARLINGTON TX 76012

Organization’s website WWW.CAMPIMPACTDFW.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/21/2011
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N20 - Recreational and Sporting Camps
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
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 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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