FORM 1023-EZ for MAD CREEK FILM INSTITUTE

Field Data
EIN 46-5497730
Case Number EO-2016120-000143
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MAD CREEK FILM INSTITUTE
Organization’s Mailing Address 802 ROBIN ROAD
City MUSCATINE
State IA
ZIP 52761-3615
Accounting period End 12
Primary contact name AARON JOHNSTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

AARON JOHNSTON
PRESIDENT, TREASURER
802 ROBIN ROAD
MUSCATINE IA 52761-3615

Officer/Director/Trustee Two

JONATHAN KELBLE
VICE-PRESIDENT
13513 CHELTENHAM DRIVE
SHERMAN OAKS CA 91423-4817

Officer/Director/Trustee Three

LISA SHAUGHNESSY
SECRETARY
1220-1 RUE ST-MATHIEU MONTREAL
QC CANADA H3H2H7

Organization’s website N/A
Organization’s email AARONDJOHNSTON@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/31/2014
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A31 - Film, Video
Organization’s purpose Charitable: Yes
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 Yes
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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