FORM 1023-EZ for TRIPLE C COMMUNITY OUTREACH INC

Field Data
EIN 84-5063318
Case Number EO-2020083-000194
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TRIPLE C COMMUNITY OUTREACH INC
Organization’s Mailing Address 612 SALEM AVENUE
City DAYTON
State OH
ZIP 45406
Accounting period End 12
Primary contact name PAULETTE MARSHALL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DIRK OGLESBY
PRESIDENT
906 WELLMEIER AVENUE
DAYTON OH 45403

Officer/Director/Trustee Two

PAULISA BROWN-SCOTT
TREASURER
1836 LITCHFIELD AVENUE
DAYTON OH 45406

Officer/Director/Trustee Three

LEONE HARRIS
SECRETARY
5200 WEINGOLD COURT
TROTWOOD OH 45426

Officer/Director/Trustee Four

ROSE SLAUGHTER
BOARD MEMBER
5257 DAYTON-LIBERTY ROAD
DAYTON OH 45417

Officer/Director/Trustee Five

VAJRICK TYMAINE
BOARD MEMBER
1059 W GRAND AVENUE
DAYTON OH 45402

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/17/2020
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 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 DIRK OGLESBY
Signature Title PRESIDENT
Signature Date 3/19/2020

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