FORM 1023-EZ for ATHLETIC HALL OF FAME FOR DALEVILLEHIGH SCHOOL INC

Field Data
EIN 87-1586090
Case Number EO-2021203-000360
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ATHLETIC HALL OF FAME FOR DALEVILLEHIGH SCHOOL INC
Organization’s Mailing Address 14300 W SECOND ST
City DALEVILLE
State IN
ZIP 47334
Accounting period End 12
Primary contact name BRIAN STATZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID PARKISON
DIRECTOR
6021 S ELMVIEW DRIVE
MUNCIE IN 47302

Officer/Director/Trustee Two

DAVID HUBBLE
DIRECTOR
14710 W CR 400S
DALEVILLE IN 47334

Officer/Director/Trustee Three

ERIN HALBERT
DIRECTOR
9100 S ANNA LANE
DALEVILLE IN 47334

Officer/Director/Trustee Four

SHANE LEISURE
DIRECTOR
15011 W 7TH STREEET
DALEVILLE IN 47334

Officer/Director/Trustee Five

MICHAEL REES
DIRECTOR
9401 S CR 750 W
DALEVILLE IN 47334

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/18/2021
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
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 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 DAVID PARKISON
Signature Title DIRECTOR
Signature Date 7/20/2021

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