FORM 1023-EZ for ADVENTIST OUTREACH MINISTRY

Field Data
EIN 72-1603185
Case Number EO-2015033-000334
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ADVENTIST OUTREACH MINISTRY
Organization’s Mailing Address 3660 WASHINGTON AVENUE
City CINCINNATI
State OH
ZIP 45219
Accounting period End 12
Primary contact name SEMUE P CHAPMAN CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BARBARA LUNGELOW
EXECUTIVE DIRECTOR
P O BOX 36465
CINCINNATI OH 45236

Officer/Director/Trustee Two

CARRIE WALKER
DIRECTOR
3603 FOREST PARK DRIVE
CINCINNATI OH 45229

Officer/Director/Trustee Three

SHERRY ENGLISH
SECY
9829 ARVIN AVENUE
CINCINNATI OH 45231

Officer/Director/Trustee Four

DARYL FOSTER
TREA
6559 OAK KNOLL DRIVE
CINCINNATI OH 45224

Officer/Director/Trustee Five

PETION COLE
DIRECTOR
1675 FELLSMERE LANE
CINCINNATI OH 45240

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/10/1998
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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 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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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