FORM 1023-EZ for INDEPENDENCE ORGANIZATION
| Field | Data |
|---|---|
| EIN | 84-4127125 |
| Case Number | EO-2021082-000915 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | INDEPENDENCE ORGANIZATION |
| Organization’s Mailing Address | PO BOX 177 |
| City | SUN CITY |
| State | CA |
| ZIP | 92586 |
| Accounting period End | 12 |
| Primary contact name | RICHARD VICEK SR |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
ANTOINETTE LIVELY
PRESIDENT
3063 E CAMBRIDGE DR
HAYDEN ID 83835
Officer/Director/Trustee Two
CHUCK REUTTER
CFO, CIO
29066 BRADLEY RD
SUN CITY CA 92586
Officer/Director/Trustee Three
RICHARD VICEK SR
SECRETARY, CEO
29147 PRESTWICK RD
SUN CITY CA 92586
Officer/Director/Trustee Four
RICHARD VICEK JR
CDO
29147 PRESTWICK RD
SUN CITY CA 92586
| Organization’s website | |
|---|---|
| Organization’s email | INDEPENDANCEORG@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 2/17/2015 |
| Organization Incorporation State | CA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E50 - Rehabilitative Medical Services |
| 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 | 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 | RICHARD VICEK SR |
| Signature Title | SECRETARY, CEO |
| Signature Date | 2/1/2021 |
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