FORM 1023-EZ for CHILDRENS ARK INTERNATIONAL INC

Field Data
EIN 84-3651880
Case Number EO-2020092-000200
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHILDRENS ARK INTERNATIONAL INC
Organization’s Mailing Address 110 SUNNY VALLEY LOOP
City WOLF CREEK
State OR
ZIP 97497
Accounting period End 12
Primary contact name ROBERT SIMONSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT SIMONSON
PRESIDENT
SUNNY VALLEY LOOP
WOLF CREEK OR 97497

Officer/Director/Trustee Two

DEBRA SIMONSON
SECRETARY
110 SUNNY VALLEY LOOP
WOLF CREEK OR 97497

Officer/Director/Trustee Three

NAVEEN VANGIVARAPU
TREASURER
110 SUNNY VALLEY LOOP
WOLF CREEK OR 97497

Officer/Director/Trustee Four

RUSS PAUL
BOARD MEMBER
110 SUNNY VALLEY LOOP
WOLF CREEK OR 97497

Officer/Director/Trustee Five

DAVE PINGLE
BOARD MEMBER
110 SUNNY VALLEY LOOP
WOLF CREEK OR 97497

Organization’s website
Organization’s email RAINFORESTCO2@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/20/2020
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G81 - AIDS
Organization’s purpose Charitable: Yes
Religious: No
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 Yes
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 ROBERT SIMONSON
Signature Title PRESIDENT
Signature Date 3/30/2020

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