FORM 1023-EZ for CLUB LIGHTHOUSE CHRISTIAN SERVICESINC

Field Data
EIN 47-4784503
Case Number EO-2015232-000369
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CLUB LIGHTHOUSE CHRISTIAN SERVICESINC
Organization’s Mailing Address PO BOX 700466
City SAN ANTONIO
State TX
ZIP 78270
Accounting period End 12
Primary contact name CHARLENE EMERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHARLENE EMERSON
PRESIDENT, DIRECTOR
PO BOX 700466
SAN ANTONIO TX 78270

Officer/Director/Trustee Two

JOHNNY DUNCAN
SECRETARY, DIRECTOR
11411 BEAR PAW PATH
SAN ANTONIO TX 78245

Officer/Director/Trustee Three

MALCOLM DAVIS
TREASURER, DIRECTOR
1029 S PEARSON ST
GREENSBORO NC 24706

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/26/2015
Organization Incorporation State TX
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: Yes
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 Yes
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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