FORM 1023-EZ for THE COMMUNITY OUTREACH WORKSHOP

Field Data
EIN 81-3626209
Case Number EO-2016348-000333
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE COMMUNITY OUTREACH WORKSHOP
Organization’s Mailing Address 25 COPPERHEAD RD
City CLYDE
State NC
ZIP 28721
Accounting period End 12
Primary contact name DAVID M MEHAFFEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID MEHAFFEY
PRESIDENT/DIRECTOR
25 COPPERHEAD RD
CLYDE NC 28721

Officer/Director/Trustee Two

JIM DAVIS
VICE PRESIDENT/DIRECTOR
85 SERENITY COVE
MAGGIE VALLEY NC 28751

Officer/Director/Trustee Three

RONALD HUNDLEY
SECRETARY/DIRECTOR
121 PISGAH DRIVE
CANTON NC 28716

Officer/Director/Trustee Four

JASON GOSSETT
TREASURER/DIRECTOR
378 WALNUT DRIVE
MAGGIE VALLEY NC 28751

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/17/2016
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: Yes
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 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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