FORM 1023-EZ for PERRY COUNTY WINTER SHELTER INC

Field Data
EIN 83-2382628
Case Number EO-2018318-000045
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PERRY COUNTY WINTER SHELTER INC
Organization’s Mailing Address 802 9TH STREET
City TELL CITY
State IN
ZIP 47586
Accounting period End 12
Primary contact name MICHAEL ELAMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOAN HESS
PRESIDENT
623 10TH STREET
TELL CITY IN 47586

Officer/Director/Trustee Two

MICHAEL ELAMAN
SECRETARY TREASURER
1146 21ST STREET
TELL CITY IN 47586

Officer/Director/Trustee Three

MARY JULIA COLBY
VICE PRESIDENT
1000 W STAR CIRCLE
SANTA CLAUS IN 47579

Officer/Director/Trustee Four

JAMIE MCLAUGHLIN
DIRECTOR
57 STEPHENSPORT LANE
STEPHENSPORT KY 47170

Officer/Director/Trustee Five

RYAN OBERHAUSEN
DIRECTOR
178 E CANDY CANE LANE
SANTA CLAUS IN 47579

Organization’s website
Organization’s email DELAMAN1146@ATT.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/26/18
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L41 - Homeless, Temporary Shelter For
Organization’s purpose Charitable: Yes
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 MICHAEL ELAMAN
Signature Title SECRETARY TREASURER
Signature Date 11/6/18

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