FORM 1023-EZ for MIAMI VALLEY HOLINESS FELLOWSHIP YOUTH CAMP INC

Field Data
EIN 85-3331018
Case Number EO-2021120-000143
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MIAMI VALLEY HOLINESS FELLOWSHIP YOUTH CAMP INC
Organization’s Mailing Address 6863 TUMBLEWEED LN
City CANAL WINCHESTER
State OH
ZIP 43110
Accounting period End 12
Primary contact name JERRY KAZEE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BENNY SUTHERLAND
DIRECTOR
3201 DRYDEN RD
DAYTON OH 45439

Officer/Director/Trustee Two

JERRY KAZEE
DIRECTOR
6863 TUMBLEWEED LN
CANAL WINCHESTER OH 43110

Officer/Director/Trustee Three

KEVIN ALLEN
SECRETARY
4668 TODD RD
FRANKLIN OH 45005

Officer/Director/Trustee Four

BRUCE MCGUIRE
DIRECTOR
7141 STIVER RD
GERMANTOWN OH 45327

Officer/Director/Trustee Five

TODD HATCHER
DIRECTOR
3612 DUST COMMANDER DR
HAMILTON OH 45011

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/5/2020
Organization Incorporation State OH
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 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 JERRY KAZEE
Signature Title DIRECTOR
Signature Date 4/28/2021

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