FORM 1023-EZ for LAFAYETTE LODGE COMMUNITY FOUNDATION INC

Field Data
EIN 82-3315062
Case Number EO-2018029-000572
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LAFAYETTE LODGE COMMUNITY FOUNDATION INC
Organization’s Mailing Address 816 EMERALD DRIVE
City LAFAYETTE
State IN
ZIP 47905
Accounting period End 12
Primary contact name DEREK REUTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LEONARD WILSON
PRESIDENT
8736 E 375 S
LAFAYETTE IN 47905

Officer/Director/Trustee Two

SEAN COURTNEY
VICE-PRESIDENT
6095 MACCLOUD COURT
WEST LAFAYETTE IN 47906

Officer/Director/Trustee Three

STEWART SCHRECKENGAST
SECRETARY
816 EMERALD COURT
LAFAYETTE IN 47905

Officer/Director/Trustee Four

DAVID RAYMER
TREASURER
2520 KOSSUTH STREET
LAFAYETTE IN 47905

Officer/Director/Trustee Five

DEREK REUTER
REGISTERED AGENT
1332 SOUTH STREET
LAFAYETTE IN 47901

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/24/17
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P28 - Neighborhood Centers, Settlement Houses
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: Yes
Amateur Sports: No
Cruelty Prevention: Yes
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 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 DEREK REUTER
Signature Title REGISTERED AGENT
Signature Date 1/27/18

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