FORM 1023-EZ for POTTER COUNTY SHERIFFS OFFICE BENEFIT BOARD

Field Data
EIN 27-4380898
Case Number EO-2017215-000096
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name POTTER COUNTY SHERIFFS OFFICE BENEFIT BOARD
Organization’s Mailing Address 608 S PIERCE
City AMARILLO
State TX
ZIP 79101-2427
Accounting period End 12
Primary contact name JOHN FREY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN FREY
CHAIRMAN
8485 CLIFFSIDE RD
AMARILLO TX 79124-4814

Officer/Director/Trustee Two

MICHELLE ANDERSON
VICE CHAIRMAN
5602 GRANADA DDR
AMARILLO TX 79109-5216

Officer/Director/Trustee Three

AMANDA WILSON
SECRETARY
3308 EDDY ST
AMARILLO TX 79109-4310

Officer/Director/Trustee Four

APRIL ROSENBAUM
TREASURER
7547 LEROY WAY
AMARILLO TX 79108-3105

Officer/Director/Trustee Five

BILLY ETHEREDGE
MEMBER
2814 ARMAND ST
AMARILLO TX 79110-2302

Organization’s website N/A
Organization’s email SO-BENEFITBOARD@CO.POTTER.TX.US
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/18/2010
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I60 - Law Enforcement Agencies (Police Departments)
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 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 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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