FORM 1023-EZ for CRICKET MEMORIAL

Field Data
EIN 83-3425768
Case Number EO-2019169-000331
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CRICKET MEMORIAL
Organization’s Mailing Address 7635 TOWNSHIP HIGHWAY 104
City UPPER SANDUSKY
State OH
ZIP 43351
Accounting period End 12
Primary contact name JASON HEILMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JASON HEILMAN
DIRECTOR
7635 TOWNSHIP HIGHWAY 104
UPPER SANDUSKY OH 43351

Officer/Director/Trustee Two

LATISHA STEIN
PROGRAM COORDINATOR
5034 ROSALIND LANE
POWELL OH 43065

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/23/03
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N02 - Management & Technical Assistance
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
Gaming Activity Yes
Disaster relief assistance Yes
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 JASON HEILMAN
Signature Title DIRECTOR
Signature Date 6/13/19

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