FORM 1023-EZ for CHRIS CLITES FOUNDATION INC

Field Data
EIN 86-1803336
Case Number EO-2021085-000458
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHRIS CLITES FOUNDATION INC
Organization’s Mailing Address 837 FORWARDPASS RD SW
City PATASKALA
State OH
ZIP 43062
Accounting period End 12
Primary contact name KEVIN RIDER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEVIN RIDER
CHIEF EXECUTIVE OFFICER / PRESIDENT
837 FORWARDPASS RD SW
PATASKALA OH 43062

Officer/Director/Trustee Two

BRENDA RIDER
TREASURER/ SECRETARY
837 FORWARDPASS RD SW
PATASKALA OH 43062

Officer/Director/Trustee Three

DONALD WOLFE
VICE PRESIDENT
2591 MCDONALD ST SW
LANCASTER OH 43130

Officer/Director/Trustee Four

JOHN HAMERCHECK
BOARD OF DIRECTORS
81 PARKWAY BLVD
MADISON OH 44057

Officer/Director/Trustee Five

CARMEN CLITES
BOARD OF DIRECTORS
231 FAIRWAY BLVD
COLUMBUS OH 43213

Organization’s website
Organization’s email Nightlightsafety@outlook.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/24/2021
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T30 - Public Foundations
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 Yes
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 KEVIN RIDER
Signature Title CHIEF EXECUTIVE OFFICER / PRESIDENT
Signature Date 2/3/2021

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