FORM 1023-EZ for THE SERVANT COMMUNITY CHURCH INC

Field Data
EIN 81-2473884
Case Number EO-2016165-000373
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE SERVANT COMMUNITY CHURCH INC
Organization’s Mailing Address 450 WEST 50TH STREET
City MARION
State IN
ZIP 46953
Accounting period End 12
Primary contact name DARRELL SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DARRELL SMITH
PRESIDENT, DIRECTOR
218 WEST 500 NORTH
ANDERSON IN 46012

Officer/Director/Trustee Two

JAMES TEETERS
V.P., DIRECTOR
311 WEST FIRST STREET
MARION IN 46952

Officer/Director/Trustee Three

KENNETH WARD
V.P., DIRECTOR
821 VIRGIL DRIVE
GAS CITY IN 46933

Officer/Director/Trustee Four

RITA WARD
V.P., DIRECTOR
821 VIRGIL DRIVE
GAS CITY IN 46933

Officer/Director/Trustee Five

SUE COOK
V.P., DIRECTOR
1614 EAST PARKVIEW DRIVE
MARION IN 46952

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/2016
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X21 - Protestant
Organization’s purpose Charitable: No
Religious: Yes
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 Yes
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
Signature Title
Signature Date

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