FORM 1023-EZ for CHILDRENS MERCY MINISTRY INC

Field Data
EIN 83-4596661
Case Number EO-2019277-000815
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHILDRENS MERCY MINISTRY INC
Organization’s Mailing Address 1110 HACIENDA AVE
City CAMPBELL
State CA
ZIP 95008
Accounting period End 12
Primary contact name ZACHARY HORSAGER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOAQUIN SALINAS
PRESIDENT
2301 REGINA COURT
SANTA CLARA CA 95054

Officer/Director/Trustee Two

ZACKARY HORSAGER
TREASURER
1110 HACIENDA AVE
CAMPBELL CA 95008

Officer/Director/Trustee Three

JULENE HORSAGER
SECRETARY
2825 WILSON COMMON
FREMONT CA 94538

Organization’s website
Organization’s email EZLIGHTHOUSE@REAGAN.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/15/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
Organization’s purpose Charitable: Yes
Religious: No
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
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 ZACKARY HORSAGER
Signature Title TREASURER
Signature Date 10/2/19

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