FORM 1023-EZ for CHRISTIAN COMMUNITY OUTREACH

Field Data
EIN 45-2970864
Case Number EO-2018016-000596
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHRISTIAN COMMUNITY OUTREACH
Organization’s Mailing Address PO BOX 1502
City SHOW LOW
State AZ
ZIP 85902-1502
Accounting period End 12
Primary contact name TOM BROWN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROD MARSHALL
BOARD MEMBER
2421 N 22ND WAY
SHOW LOW AZ 85901

Officer/Director/Trustee Two

TOM BROWN
TREASURER
151 S 14TH DR
SHOW LOW AZ 85901

Officer/Director/Trustee Three

BILL BUSNOWSKI
BOARD MEMBER
972 CHENEY RANCE
SHOW LOW AZ 85901

Officer/Director/Trustee Four

DAVID EMBREY
PRESIDENT
601 S CLARK ROAD
SHOW LOW AZ 85901

Officer/Director/Trustee Five

TED LAMBERT
BOARD MEMBER
1081 DUSTY LANE
SHOW LOW AZ 85901

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/10
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P60 - Emergency Assistance (Food, Clothing, Cash)
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 Yes
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 TOM BROWN
Signature Title TREASURER
Signature Date 1/14/18
EIN 45-2970864
Case Number EO-2014288-000026
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHRISTIAN COMMUNITY OUTREACH INCORPORATED
Organization’s Mailing Address PO BOX 1502
City SHOW LOW
State AZ
ZIP 85902-1502
Accounting period End 12
Primary contact name THOMAS A BROWN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

THOMAS A BROWN
SECRETARY
141 SOUTH 14TH DRIVE
SHOW LOW AZ 85901-5756

Officer/Director/Trustee Two

JANICE HANSEN
TREASURER
1260 W MCNEIL
SHOW LOW AZ 85901-5756

Officer/Director/Trustee Three

TED LAMBERT
DIRECTOR
PO BOX 1502
SHOW LOW AZ 85902-1502

Officer/Director/Trustee Four

JENNIFER HAGEMAN
DIRECTOR
PO BOX 1502
SHOW LOW AZ 85902-1502

Officer/Director/Trustee Five

RODNEY MARSHALL
DIRECTOR
PO BOX 1502
SHOW LOW AZ 85902-1502

Organization’s website NA
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/2010
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P60 - Emergency Assistance (Food, Clothing, Cash)
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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