FORM 1023-EZ for CLEVELAND STREET CHURCH

Field Data
EIN 81-3859274
Case Number EO-2016298-000330
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CLEVELAND STREET CHURCH
Organization’s Mailing Address 1582 COUNTY ROAD 7
City NEW ALBANY
State MS
ZIP 38650
Accounting period End 12
Primary contact name MATTHEW GOOCH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAMAR MOFFITT
INCORPORATOR
1448 COUNTY ROAD 73 LOT 3
MYRTLE MS 38650

Officer/Director/Trustee Two

LUKE GOOCH
INCORPORATOR
1152 COUNTY ROAD 7
HICKORY FLAT MS 38633

Officer/Director/Trustee Three

ROGER BROWNING
INCORPORATOR
1122 COUNTY ROAD 126
NEW ALBANY MS 38652

Officer/Director/Trustee Four

MATTHEW GOOCH
INCORPORATOR
1582 COUNTY ROAD 7
MYRTLE MS 38650

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/15/2016
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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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