FORM 1023-EZ for GREEN COUNTRY CLASSIC WORKING RANCHCOWBOYS CRISIS FOUNDATION

Field Data
EIN 81-2844891
Case Number EO-2016174-000139
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GREEN COUNTRY CLASSIC WORKING RANCHCOWBOYS CRISIS FOUNDATION
Organization’s Mailing Address PO BOX 196
City RAMONA
State OK
ZIP 74061
Accounting period End 12
Primary contact name LESTER GAGAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LESTER GAGAN
OFFICER
31510 N 3990 RD
RAMONA OK 74061

Officer/Director/Trustee Two

JERRY WRIGHT
OFFICER
RR1 BOX 226
NOWATA OK 74048-9736

Officer/Director/Trustee Three

TODD TIEPERMAN
OFFICER
10102 N 161ST E AVE
OWASSO OK 74055

Officer/Director/Trustee Four

SHANNON ADCOCK
OFFICER
403520 W 1800 RD
BARTLESVILLE OK 74006

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/6/2016
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D12 - Fund Raising and/or Fund Distribution
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 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

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