FORM 1023-EZ for CLUB SHINING STARS INC

Field Data
EIN 47-3072971
Case Number EO-2015043-000339
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CLUB SHINING STARS INC
Organization’s Mailing Address 8756 PATTERSON STREET
City SAINT JOHN
State IN
ZIP 46373
Accounting period End 12
Primary contact name FAWN NOWAK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

FAWN NOWAK
DIRECTOR
8756 PATTERSON STREET
SAINT JOHN IN 46373

Officer/Director/Trustee Two

JOHN W POSKIN
TREASURER
8756 PATTERSON STREET
SAINT JOHN IN 46373

Officer/Director/Trustee Three

JOHN A POSKIN
SECRETARY
22418 YATES AVE
SAUK VILLAGE IL 60411

Organization’s website
Organization’s email CSS.POSKIN@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/9/2015
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P82 - Developmentally Disabled Centers, Services
Organization’s purpose Charitable: Yes
Religious: No
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 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
Signature Title
Signature Date

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