FORM 1023-EZ for CAMP MOSS HOLLOW ALUMNI

Field Data
EIN 83-3129769
Case Number EO-2019050-000134
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CAMP MOSS HOLLOW ALUMNI
Organization’s Mailing Address 5302 CLARIDGE COURT
City TEMPLE
State MD
ZIP 20748
Accounting period End 12
Primary contact name JAMES C GOODWIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHESTER E WATERS JR
BOARD MEMBER
15712 RHONE COURT
ACCOKEEK MD 20607

Officer/Director/Trustee Two

TERRI REDD ELLERBE
BOARD MEMBER
15208 RICHARD BOWIE LANE
UPPER MARLBORO MD 20774

Officer/Director/Trustee Three

DONTE BERRY
BOARD MEMBER
5554 LIVINGSTON TERR APT 101
OXON HILL MD 20745

Officer/Director/Trustee Four

CYNTHIA L DORSEY
BOARD MEMBER
5048 13TH STREET NE
WASHINGTON DC 20017

Officer/Director/Trustee Five

JAMES C GOODWIN
BOARD MEMBER
5302 CLARIDGE COURT
TEMPLE HILLS MD 20748

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/12/19
Organization Incorporation State MD
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: 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 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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JAMES C GOODWIN
Signature Title BOARD MEMBER
Signature Date 2/14/19

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