FORM 1023-EZ for MODOC PERFORMING ARTS THEATER

Field Data
EIN 47-1361010
Case Number EO-2015365-000300
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MODOC PERFORMING ARTS THEATER
Organization’s Mailing Address PO BOX 1048
City ALTURAS
State CA
ZIP 96101-1048
Accounting period End 12
Primary contact name SADIE CAMACHO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SADIE CAMACHO
PRESIDENT
HC3 BOX 52
ALTURAS CA 96101-9003

Officer/Director/Trustee Two

KAREN HAYS
VICE PRESIDENT
501 N EAST B STREET
ALTURAS CA 96101-3429

Officer/Director/Trustee Three

MAGGI DUNCAN
TREASURER
HC04 BOX 45004
ALTURAS CA 96101-9512

Officer/Director/Trustee Four

DAN ROEDER
SECRETARY
106 N DANHAUSER
ALTURAS CA 96101-3830

Officer/Director/Trustee Five

CHENOAH LAUPPE
HISTORIAN-DIRECTOR
1106 W CARLOS
ALTURAS CA 96101-3723

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/3/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A60 - Performing Arts Organizations
Organization’s purpose Charitable: No
Religious: No
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 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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