FORM 1023-EZ for ARKANSAS COMMUNITY HEALTH WORKER ASSOCIATION

Field Data
EIN 47-3544996
Case Number EO-2015121-000155
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ARKANSAS COMMUNITY HEALTH WORKER ASSOCIATION
Organization’s Mailing Address 107 PROFESSIONAL PLAZA
City HELENA
State AR
ZIP 72342
Accounting period End 12
Primary contact name NAOMI COTTOMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NAOMI COTTOMS
CHAIR
1118 PORTER ST
HELENA AR 72342

Officer/Director/Trustee Two

DELOIS HARE
OFFICER
PO BOX 661
MARIANNA AR 72360

Officer/Director/Trustee Three

LINDA AUSTIN
OFFICER
761 HWY 65
DUMAS AR 71639

Organization’s website WWW.ARCHWA.ORG
Organization’s email INFO@ARCHWA.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/24/2015
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E03 - Professional Societies, Associations
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
Signature Title
Signature Date

Recently Saved Organizations

Click on the save icon from a search results or organization page.