FORM 1023-EZ for IN HIS NAME OUTREACH INC

Field Data
EIN 47-3857280
Case Number EO-2015169-000257
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name IN HIS NAME OUTREACH INC
Organization’s Mailing Address 3871 HARLEM RD
City CHEEKTOWAGA
State NY
ZIP 14215
Accounting period End 12
Primary contact name DONNA POTTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DONNA POTTER
PRESIDENT
1887 COMO PARK BLVD
LANCASTER NY 14086

Officer/Director/Trustee Two

GWENDOLYN BORK
VICE PRESIDENT
3101 TOWNLINE RD
ALDEN NY 14004

Officer/Director/Trustee Three

RICHARD ZIELINSKI
TREASURER
531 ELMA MEADOW LANE
ELMA NY 14059

Officer/Director/Trustee Four

AMELIA GRISWOLD
SECRETARY
9620 GREINER RD
CLARENCE NY 14031

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/2/2015
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: Yes
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 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 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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