FORM 1023-EZ for LIBERIAN ASSOCIATION OF ARIZONA

Field Data
EIN 80-0122797
Case Number EO-2015113-000101
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIBERIAN ASSOCIATION OF ARIZONA
Organization’s Mailing Address 17 E KELLY LANE
City TEMPE
State AZ
ZIP 85284-4065
Accounting period End 12
Primary contact name ROOSEVELT GAYSUE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT BOB SHERMAN
PRESIDENT
17 E KELLY LANE
TEMPE AZ 85284-4065

Officer/Director/Trustee Two

ED COOPER
VICE PRESIDENT
8317 W COCOPAH STREET
TOLLENSON AZ 85335

Officer/Director/Trustee Three

ANITA MAMY
SECRETARY
13421 N 43RD AVENUE 3083
PHOENIX AZ 85029

Officer/Director/Trustee Four

ROOSEVELT GAYSUE
TREASURER
19972 N 63RD DRIVE
GLENDALE AZ 85308-7073

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/23/2004
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 No
Donation of funds No
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 Yes
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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