FORM 1023-EZ for LADY INDIANS DIAMOND CLUB

Field Data
EIN 47-5358413
Case Number EO-2016011-000386
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LADY INDIANS DIAMOND CLUB
Organization’s Mailing Address PO BOX 494
City MONTICELLO
State IN
ZIP 47960
Accounting period End 12
Primary contact name KRISTIN MARVIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PAM FLAHERTY
PRESIDENT
1248 N 725 E
MONTICELLO IN 47960

Officer/Director/Trustee Two

JESSICA APPLEGATE
VICE-PRESIDENT
10142 E 475 N
IDAVILLE IN 47950

Officer/Director/Trustee Three

SAMANTHA FOUTCH
SECRETARY
2287 N EAST SHAFER DR
MONTICELLO IN 47960

Officer/Director/Trustee Four

KRISTIN MARVIN
TREASURER
2972 N 400 E
MONTICELLO IN 47960

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/4/2015
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N11 - Single Organization Support
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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
Signature Title
Signature Date

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