FORM 1023-EZ for WISHBONE ORTHOPAEDIC FOUNDATION INC

Field Data
EIN 82-3534570
Case Number EO-2021097-000354
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WISHBONE ORTHOPAEDIC FOUNDATION INC
Organization’s Mailing Address PO BOX 211
City WARSAW
State IN
ZIP 46581
Accounting period End 12
Primary contact name WESLEY R CARTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROB SEEWALD
PRESIDENT/ DIRECTOR
6455 N 800 W
ETNA GREEN IN 46524

Officer/Director/Trustee Two

ROBERT VON SEGGERN
TREASURER/ DIRECTOR
4177 N SR 9
COLUMBIA CITY IN 46725

Officer/Director/Trustee Three

CYNDI LEVINE
DIRECTOR
904 CALAMINT LANE
FAYETTEVILLE NC 28305

Officer/Director/Trustee Four

KEVIN BLUE
DIRECTOR
29 W 172ND ST S
MOUNDS OK 74047

Officer/Director/Trustee Five

MICHAEL KING
DIRECTOR
2448 E 81ST STREET SUITE 5900
TULSA OK 74137

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/22/2017
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Q33 - International Relief
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: Yes
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 Yes
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 MICHAEL KING
Signature Title DIRECTOR
Signature Date 3/11/2021

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