FORM 1023-EZ for CREATIVE OUTLET THEATRE ENSEMBLE

Field Data
EIN 45-4944543
Case Number EO-2015056-000118
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CREATIVE OUTLET THEATRE ENSEMBLE
Organization’s Mailing Address 123 N JEFFERSON ST
City MT PLEASANT
State IA
ZIP 52641
Accounting period End 12
Primary contact name ERIC TEETER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ERIC TEETER
EXECUTIVE/ARTISTIC DIRECTOR
1107 E LINDEN DR APT 307
MT PLEASANT IA 52641

Officer/Director/Trustee Two

ZACH ROCKER
SECRETARY
127 N JEFFERSON ST APT 301
MT PLEASANT IA 52641

Officer/Director/Trustee Three

JUDY KEOMANIVONG
BOARD MEMBER
1751 265TH ST
MT PLEASANT IA 52641

Officer/Director/Trustee Four

MATT CRULL
VICE PRESIDENT OF THE BOARD
702 S REDBUD RIDGE
MT PLEASANT IA 52641

Officer/Director/Trustee Five

JENNIFER CRULL
PRESIDENT OF THE BOARD
702 S REDBUD RIDGE
MT PLEASANT IA 52641

Organization’s website
Organization’s email COTEDIRECTOR@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/25/2012
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A65 - Theater
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 Yes
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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