FORM 1023-EZ for CHAMPIONS FOR JESUS INC

Field Data
EIN 87-1289822
Case Number EO-2021181-000206
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHAMPIONS FOR JESUS INC
Organization’s Mailing Address 103 FELDSPAR LN
City GREER
State SC
ZIP 29650-5335
Accounting period End 12
Primary contact name ROBERTA ROMERO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERTA ROMERO
PRESIDENT
103 FELDSPAR LN
GREER SC 29650-5335

Officer/Director/Trustee Two

DANIEL VAN DER HOEVEN
TREASURER
6701 EASTON PL
CHARLOTTE NC 28212-5649

Officer/Director/Trustee Three

KELLI VAN DER HOEVEN
SECRETARY
6701 EASTON PL
CHARLOTTE NC 28212-5649

Officer/Director/Trustee Four

MONICA COX
BOARD MEMBER
112111 HAERING CIR
CHASKA MN 55318-1378

Officer/Director/Trustee Five

LEIZA PALPANT
BOARD MEMBER
10720 TRAYMORE LN
CHARLOTTE NC 28278-6823

Organization’s website WWW.CHAMPIONS4JESUS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/20/2021
Organization Incorporation State SC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
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 Yes
Conducting Activities Outside of United States Yes
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 ROBERTA ROMERO
Signature Title PRESIDENT
Signature Date 6/29/2021

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