FORM 1023-EZ for DALEVILLE PARKS INC

Field Data
EIN 47-2219228
Case Number EO-2015146-000188
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DALEVILLE PARKS INC
Organization’s Mailing Address 8019 S WALNUT ST
City DALEVILLE
State IN
ZIP 47334
Accounting period End 12
Primary contact name LESLIE MATHEWSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BEN FISHER
PRESIDENT
15020 W 4TH ST
DALEVILLE IN 47334

Officer/Director/Trustee Two

BRAD REAL
VICE PRESIDENT
8413 W WALNUT ST
DALEVILLE IN 47334

Officer/Director/Trustee Three

THOMAS ROBERTS
SECRETARY TREASURER
13919 W MAIN ST
DALEVILLE IN 47334

Officer/Director/Trustee Four

JAY SHELLABARGER
DIRECTOR
13719 W MAIN ST
DALEVILLE IN 47334

Officer/Director/Trustee Five

SEAN STEWART
DIRECTOR
7300 S RIVER RD
DALEVILLE IN 47334

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/31/2014
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 Yes
One Third Support Gifts No
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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