FORM 1023-EZ for AGAPE COMMUNITY CENTER

Field Data
EIN 46-3886030
Case Number EO-2015190-000346
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AGAPE COMMUNITY CENTER
Organization’s Mailing Address 844 E 100 S
City PAYSON
State UT
ZIP 84651
Accounting period End 12
Primary contact name MARIA ZAMBRANO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARIA ZAMBRANO
PRESIDENT
844 E 100 S
PAYSON UT 84651

Officer/Director/Trustee Two

JACKIE BUSHINSKIE
DIRECTOR
110 S 300 E
SPANISH FORK UT 84660

Officer/Director/Trustee Three

LAURA GODOY
SECRETARY
824 W 700 N
PROVO UT 84604

Officer/Director/Trustee Four

HYRUM SKINNER
DIRECTOR
750 E 100 N APT 11
PAYSON UT 84651

Officer/Director/Trustee Five

LARRY BROWN
DIRECTOR
43 E UTAH AVE
PAYSON UT 84651

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/8/2013
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P29 - Thrift Shops
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 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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