FORM 1023-EZ for DIGNITY HOME SERVICES INCORPORATED

Field Data
EIN 81-4800739
Case Number EO-2017040-000173
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DIGNITY HOME SERVICES INCORPORATED
Organization’s Mailing Address 4532 INDIANOLA AVE
City INDIANAPOLIS
State NY
ZIP 46205-2039
Accounting period End 12
Primary contact name KAREN BANKS-MOHAMADOU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KAREN BANKS-MAHAMADOU
CHAIR
4352 INDIANOLA AVE
INDIANAPOLIS IN 46205-2039

Officer/Director/Trustee Two

CHARLENE WILLIAMS
TREASURER
6125 CANDLEWICK DRIVE
INDIANAPOLIS IN 46228-1084

Officer/Director/Trustee Three

SHARON BAUGH
SECRETARY
2057 BOULDER DRIVE APT G212
INDIANAPOLIS IN 46260-3038

Officer/Director/Trustee Four

SUSIE HARRIS
DIRECTOR
5346 N DAVID ST
INDIANAPOLIS IN 46226-1732

Officer/Director/Trustee Five

LADONNA FREEMAN
DIRECTOR
1110 S ILLINOIS ST
INDIANAPOLIS IN 46225-1412

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/21/2016
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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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