FORM 1023-EZ for ADAMS COUNTY CITIZENS FOR SAFE SCHOOLS INC

Field Data
EIN 83-1614166
Case Number EO-2018232-000537
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ADAMS COUNTY CITIZENS FOR SAFE SCHOOLS INC
Organization’s Mailing Address 1295 DOTSON RD
City SEAMAN
State OH
ZIP 45679-9524
Accounting period End 12
Primary contact name THOMAS PUTNAM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THOMAS PUTNAM
PRESIDENT
1295 DOTSON RD
SEAMAN OH 45679-9524

Officer/Director/Trustee Two

BETSY HESLER
TREASURER
1955 FOSTER RD
WEST UNION OH 45693

Officer/Director/Trustee Three

MOLLY GROOMS
MEMBER
1659 DOTSON RD
SEAMAN OH 45679

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/15/18
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W24 - Citizen Participation
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 THOMAS PUTNAM
Signature Title PRESIDENT
Signature Date 8/17/18

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