FORM 1023-EZ for FREMONT YOUTH FOUNDATION CORP

Field Data
EIN 83-1488710
Case Number EO-2018221-000367
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FREMONT YOUTH FOUNDATION CORP
Organization’s Mailing Address 2836 COUNCIL OAK DRIVE
City SOUTH BEND
State IN
ZIP 46628
Accounting period End 12
Primary contact name KIMBERLY CLOWERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIMBERLY CLOWERS
PRESIDENT
1648 NORTH ELMER STREET
SOUTH BEND IN 46628

Officer/Director/Trustee Two

VALERIE CHAVERS
VICE-PRESIDENT AND TREASURER
2836 COUNCIL OAK DRIVE
SOUTH BEND IN 46628

Officer/Director/Trustee Three

REGINA WILLIAMS-PRESTON
SECRETARY
838 NORTH ELMER STREET
SOUTH BEND IN 46628

Officer/Director/Trustee Four

NOSHA CASEY
BOARD MEMBER
1902 NORTH FREMONT AVENUE
SOUTH BEND IN 46628

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/15/17
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I21 - Delinquency Prevention
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KIMBERLY CLOWERS
Signature Title PRESIDENT
Signature Date 8/7/18

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