FORM 1023-EZ for CHRIST PROVISION OUTREACH MINISTRY

Field Data
EIN 84-3863261
Case Number EO-2019340-000294
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHRIST PROVISION OUTREACH MINISTRY
Organization’s Mailing Address 5876 W FAYETTEVILLE RD
City COLLEGE PARK
State GA
ZIP 30349
Accounting period End 12
Primary contact name TERRY L HARRIS SR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TERRY HARRIS
PASTOR
4033 CASTLE WAY
FAIRBURN GA 30213

Officer/Director/Trustee Two

KATHY HARRIS
CO-PASTOR
4033 CASTLE WAY
FAIRBURN GA 30213

Officer/Director/Trustee Three

DAVID WILLIAMS
CHAIRMAN
1265 PIXLEY DRIVE
RIVERDAE GA 30296

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/1/2019
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
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 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 No
Correctness Declaration Yes
Signature Name TERRY HARRIS
Signature Title PASTOR
Signature Date 12/4/2019

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