FORM 1023-EZ for CHARLES COUNTY BLACK OFFICERS ASSOCIATION

Field Data
EIN 47-4673586
Case Number EO-2015240-000351
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHARLES COUNTY BLACK OFFICERS ASSOCIATION
Organization’s Mailing Address 2702 ADELPHI LANE
City BRYANS ROAD
State MD
ZIP 20616-3082
Accounting period End 12
Primary contact name AUGUSTUS PROCTOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CALVIN ROBERTS
PRESIDENT
2702 ADELPHI LANE
BRYANS ROAD MD 20616

Officer/Director/Trustee Two

ROCHELLE WILLIAMS
SECRETARY
38518 DOROTHY MAE COURT
CLEMENTS MD 20624

Officer/Director/Trustee Three

RALPH PETERS
VICE PRESIDENT
10644 LONG LEAF LANE
WALDORF MD 20603

Officer/Director/Trustee Four

AUGUSTUS PROCTOR
TREASURER
10821 TRINITY CHURCH ROAD
CHARLOTTE HALL MD 20622

Officer/Director/Trustee Five



Post Office Box 558

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/13/2015
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O54 - Youth Development - Citizenship Programs
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 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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