FORM 1023-EZ for JASONVILLE SENIOR CITIZEN CENTER INC

Field Data
EIN 81-5169709
Case Number EO-2017069-000248
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JASONVILLE SENIOR CITIZEN CENTER INC
Organization’s Mailing Address 145 1/2 S LAWTON ST
City JASONVILLE
State IN
ZIP 47438
Accounting period End 12
Primary contact name FRED HUBBELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

FRED HUBBELL
PRESIDENT
15182 W 800 N
JASONVILLE IN 47438

Officer/Director/Trustee Two

RICK TAYLOR
VICE PRESIDENT
12639 W ST RD 48
JASONVILLE IN 47438

Officer/Director/Trustee Three

MERILYNN MOORE
SECRETARY
4758 W 1300 S
JASONVILLE IN 47438

Officer/Director/Trustee Four

NAOMI THOMAS
TREASURER
713 E SYCAMORE ST
JASONVILLE IN 47438

Officer/Director/Trustee Five

MAX MITCHELL
BOARD MEMBER
150 S LAKEVIEW DR
TERRE HAUTE IN 47803

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/20/2017
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P81 - Senior 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 Yes
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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