FORM 1023-EZ for INDIANA CHAPTER OF AFCC INC

Field Data
EIN 46-1907289
Case Number EO-2014246-000188
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name INDIANA CHAPTER OF AFCC INC
Organization’s Mailing Address 3421 EAST STATE BOULEVARD
City FORT WAYNE
State IN
ZIP 46805
Accounting period End 12
Primary contact name SUSAN DWYER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

REBECCA BILLICK
PRESIDENT
PO BOX 1250
VALPARAISO IN 46384

Officer/Director/Trustee Two

JOHN SHANKS
VICE PRESIDENT
349 N 500W
ANDERSON IN 46011

Officer/Director/Trustee Three

EMILY BUBB
SECRETARY
9302 N MERIDIAN ST SUITE 350
INDIANAPOLIS IN 46260

Officer/Director/Trustee Four

SUSAN DWYER
TREASURER
3421 EAST STATE BOULEVARD
FORT WAYNE IN 46805

Officer/Director/Trustee Five

CHRISTOPHER BARROWS
PRESIDENT ELECT
PO BOX 232
WESTFIELD IN 46074

Organization’s website WWW.INDIANAAFCC.ORG/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/16/2012
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W03 - Professional Societies, Associations
Organization’s purpose Charitable: No
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 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 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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