FORM 1023-EZ for PROBLEM GAMBLING OUTREACH OF INDIANA INC
| Field | Data |
|---|---|
| EIN | 45-5504643 |
| Case Number | EO-2016027-000122 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | PROBLEM GAMBLING OUTREACH OF INDIANA INC |
| Organization’s Mailing Address | 2939 STAMM AVE |
| City | INDIANAPOLIS |
| State | IN |
| ZIP | 46240 |
| Accounting period End | 12 |
| Primary contact name | JOSEPH SCOTT |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
Officer/Director/Trustee One
MICHAEL GOLDBERG
PRESIDENT
333 MASSACHUSETTS AVE 301
INDIANAPOLIS IN 46204
Officer/Director/Trustee Two
SANDRA FONTANIN
TREASURER
2939 STAMM AVE
INDIANAPOLIS IN 46240
Officer/Director/Trustee Three
SUSAN MAY
SECRETARY
4613 S SHERMAN DR
INDIANAPOLIS IN 46237
Officer/Director/Trustee Four
CHUCK BOVIS
DIRECTOR
3556 TOWNE DR
CARMEL IN 46032
Officer/Director/Trustee Five
JOSEPH SCOTT
DIRECTOR
484 E CARMEL DR 379
CARMEL IN 46032
| Organization’s website | PGOINDIANA.ORG |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 5/24/2012 |
| Organization Incorporation State | IN |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F54 - Gambling Addiction |
| 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 | Yes |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | |
| Signature Title | |
| Signature Date |
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