FORM 1023-EZ for CAMP JEAN INC

Field Data
EIN 27-2311742
Case Number EO-2016146-000158
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CAMP JEAN INC
Organization’s Mailing Address 1530 CORINTH RD
City LAWRENCEBURG
State KY
ZIP 40342
Accounting period End 12
Primary contact name JEAN GIBOWSKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JEAN GIBOWSKI
DIRECTOR
1530 CORINTH RD
LAWRENCEBURG KY 40342

Officer/Director/Trustee Two

SUSAN BLALOCK
PRESIDENT
2760 LOCKURST
LEXINGTON KY 40515

Officer/Director/Trustee Three

SUSAN HUGHES
TREASURER
2015 CROWN POINT
FRANKFORT KY 40601

Officer/Director/Trustee Four

ZOLA VENNON
SECRETARY
6812 HOLLY LAKE DR
LOUISVILLE KY 40291

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/12/2016
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
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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