FORM 1023-EZ for PROCLAIM HIS NAME

Field Data
EIN 85-2610478
Case Number EO-2020237-000199
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PROCLAIM HIS NAME
Organization’s Mailing Address 4717 S CLARKSON ST
City ENGLEWOOD
State CO
ZIP 80113
Accounting period End 12
Primary contact name TOM ADAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TOM ADAMS
PRESIDENT
4717 S CLARKSON ST
ENGLEWOOD CO 80113

Officer/Director/Trustee Two

STEPHANIE ADAMS
TREASURER
4717 S CLARKSON ST
ENGLEWOOD CO 80113

Officer/Director/Trustee Three

WAYNE MCGINNIS
DIRECTOR
4717 S CLARKSON ST
ENGLEWOOD CO 80113

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/19/2020
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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 TOM ADAMS
Signature Title PRESIDENT
Signature Date 8/20/2020

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