FORM 1023-EZ for AVA CITIZENS ACTION LEAGUE

Field Data
EIN 82-0800323
Case Number EO-2017198-000308
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AVA CITIZENS ACTION LEAGUE
Organization’s Mailing Address PO BOX 939
City AVA
State MO
ZIP 65608-0939
Accounting period End 12
Primary contact name JANICE LORRAIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEAN FARBIN
PRESIDENT
133 S JEFFERSON
AVA MO 65608-0939

Officer/Director/Trustee Two

RICHARD SALGADO
VICE-PRES
RT 6 B0X 8286
AVA MO 65608

Officer/Director/Trustee Three

ROBERT SORENSEN
TREASURER
RT 5 BOX 278
AVA MO 65608

Officer/Director/Trustee Four

DARLENE SORENSEN
SECRETARY
RT 5 B0X 278
AVA MO 65608

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/6/2017
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 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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