FORM 1023-EZ for BLIND SOCIAL CENTER INC

Field Data
EIN 47-1080404
Case Number EO-2014346-000269
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLIND SOCIAL CENTER INC
Organization’s Mailing Address 5037 BROADWAY
City GARY
State IN
ZIP 46409
Accounting period End 12
Primary contact name DOUGLAS KVACHKOFF
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TONY BLAIR
CHAIRMAN
5110 MADISON STREET
GARY IN 46408

Officer/Director/Trustee Two

CONNIE BLAIR
TREASURER
5110 MADISON STREET
GARY IN 46408

Officer/Director/Trustee Three

CALVIN LEWIS
DIRECTOR
1601 WEST 53RD AVENUE
MERRILLVILLE IN 46410

Officer/Director/Trustee Four

CYNTHIA HAMILTON
DIRECTOR
335 WEST 51ST AVENUE
GARY IN 46408

Officer/Director/Trustee Five

DOUGLAS KVACHKOFF
DIRECTOR
325 NORTH MAIN STREET
CROWN POINT IN 46307-0325

Organization’s website
Organization’s email BLINDSOCIALCENTER@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/17/2014
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P86 - Blind/Visually Impaired Centers, Services
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 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
Signature Title
Signature Date

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