FORM 1023-EZ for OUTREACH CHURCH

Field Data
EIN 81-5175851
Case Number EO-2017048-000135
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name OUTREACH CHURCH
Organization’s Mailing Address 301 PEARCE STREET
City PRINCETON
State NC
ZIP 27569
Accounting period End 12
Primary contact name LARRY WITHROW
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LARRY WITHROW
PRESIDENT
301 PEARCE STREET
PRINCETON NC 27569

Officer/Director/Trustee Two

KIMBERLY TART
SECRETARY
2592 JUNIPER CHURCH ROAD
FOUR OAKS NC 27524

Officer/Director/Trustee Three

TRACY JOHNSON
TREASURER
117 EAST STONEYBOOK ROAD
BENSON NC 27504

Officer/Director/Trustee Four

ALLISON SMITH
ASSISTANT SECRETARY
81 SHADE TREE ROAD
BENSON NC 27504

Officer/Director/Trustee Five

JAMES NORRIS
ASSISTANT TREASURER
101 PHYLLIS DRIVE
BENSON NC 27504

Organization’s website
Organization’s email SACA123@EMBARQMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/19/1917
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X21 - Protestant
Organization’s purpose Charitable: Yes
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 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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