FORM 1023-EZ for CENTRAL VALLEY REFORMATION CENTER

Field Data
EIN 82-2090563
Case Number EO-2017201-000138
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CENTRAL VALLEY REFORMATION CENTER
Organization’s Mailing Address 421 1/2 POLLASKY AVE
City CLOVIS
State CA
ZIP 93612
Accounting period End 12
Primary contact name MARK PETERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EDWARD FLORES
PRESIDENT
720 WOODWORTH AVE APT 102
CLOVIS CA 93612

Officer/Director/Trustee Two

LINDA FLORES
SECRETARY
720 WOODWORTH AVE APT 102
CLOVIS CA 93612

Officer/Director/Trustee Three

MICHAEL REITH
TREASURER
2309 MINARETS
FRESNO CA 93720

Officer/Director/Trustee Four

RONNIE BOCK
DIRECTOR
238 CAESAR AVE
CLOVIS CA 93612

Officer/Director/Trustee Five

DAVID INKS
DIRECTOR
2743 HORNET AVE
CLOVIS CA 93611

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/22/2017
Organization Incorporation State CA
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 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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