FORM 1023-EZ for BLACKFORD COUNTY SECRET FAMILIES

Field Data
EIN 83-3824341
Case Number EO-2019296-000393
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACKFORD COUNTY SECRET FAMILIES
Organization’s Mailing Address PO BOX 241
City HARTFORD CITY
State IN
ZIP 47348
Accounting period End 12
Primary contact name DEB WORSTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIMBERLY FEAR
ASSISTANT DIRECTOR
1255 NORTH 300 EAST
HARTFORD CITY IN 47348

Officer/Director/Trustee Two

BRITTANY FEAR
ASSISTANT DIRECTOR
6633 WEST DICKENS XING
MCCORDSVILLE IN 46055

Officer/Director/Trustee Three

DEBRA WORSTER
DIRECTOR
2584 SOUTH WILLMAN RD
HARTFORD CITY IN 47348

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/4/19
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P58 - Gift Distribution
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 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 DEBRA WORSTER
Signature Title DIRECTOR
Signature Date 10/21/19

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