FORM 1023-EZ for LIBERTY CAMP FOR KIDS

Field Data
EIN 81-1414318
Case Number EO-2018031-000210
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LIBERTY CAMP FOR KIDS
Organization’s Mailing Address 780 CRACKEL RD
City AURORA
State OH
ZIP 44202-9799
Accounting period End 12
Primary contact name ANNE KACZMAREK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANNE KACZMAREK
PRESIDENT
780 CRACKEL RD
AURORA OH 44202-9799

Officer/Director/Trustee Two

NANETTE ZAWISTOWSKI
VICE-PRESIDENT
2549 CANFIELD RD
AKRON OH 44312-3819

Officer/Director/Trustee Three

BRENDA DERREBERRY
TREASURER
482 HERBERT RD
AKRON OH 44312-2216

Officer/Director/Trustee Four

RITA SCOTT
SECRETARY
206 ST ANDREWS LANE
AURORA OH 44202-9799

Officer/Director/Trustee Five

LANNY DERREBERRY
CHAIRMAN OF THE BOARD
482 HERBERT ROAD
AKRON OH 44312-2216

Organization’s website WWW.LIBERTYCAMPFORKIDS.COM
Organization’s email LIBERTYCAMPFORKIDS@ATT.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/8/16
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B99 - Education N.E.C.
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 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 ANNE KACZMAREK
Signature Title PRESIDENT
Signature Date 1/29/18

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