FORM 1023-EZ for JANE ROSS REEVES OCTAGON HOUSE

Field Data
EIN 35-1967197
Case Number EO-2017244-000115
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JANE ROSS REEVES OCTAGON HOUSE
Organization’s Mailing Address BOX 456 127 NOBLE ST
City SHIRLEY
State IN
ZIP 47384
Accounting period End 12
Primary contact name VIRGINIA HARRELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DON HAMMER
PRESIDENT
PO BOX 256
SHIRLEY IN 47384

Officer/Director/Trustee Two

DENNIS WESTRICH
TREASURER
PO BOX 341
SHIRLEY IN 47384

Officer/Director/Trustee Three

RICHARD MEREDITH
VICE PRESIDENT
66 LONGFELLOW LANE
GREENFIELD IN 46140

Officer/Director/Trustee Four

VIRGINIA HARRELL
BOARD MEMBER
127 NOBLE ST
SHIRLEY IN 47384

Officer/Director/Trustee Five

YVONNE MOROSE
SECRETARY
PO BOX 513
SHIRLEY IN 47384

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/18/1994
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S99 - Community Improvement, Capacity Building N.E.C.
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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