FORM 1023-EZ for THE WESTERVILLE LIONS CLUB FOUNDATION

Field Data
EIN 32-0467239
Case Number EO-2015203-000354
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE WESTERVILLE LIONS CLUB FOUNDATION
Organization’s Mailing Address PO BOX 597
City WESTERVILLE
State OH
ZIP 43086-0597
Accounting period End 6
Primary contact name JAMES SHIVELY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES SHIVELY
TREASURER
177 JUNIPER AVENUE
WESTERVILLE OH 43081-5053

Officer/Director/Trustee Two

JUNE RIGGS
SECRETARY
5520 COPENHAGEN DRIVE
WESTERVILLE OH 43081-4210

Officer/Director/Trustee Three

AIMEE WESTLUND
PRESIDENT
1366 WORTHINGTON WOODS BLVD
WORTHINGTON OH 43085-4748

Officer/Director/Trustee Four

HOWARD BAUM
FIRST VICE PRESIDENT
28 KEETHLER DRIVE
WESTERVILLE OH 43081-1939

Officer/Director/Trustee Five

ANN PRYFOGLE
SECOND VICE PRESIDENT
128 TRIESTA PLACE
WESTERVILLE OH 43081-2905

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/19/2015
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
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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