FORM 1023-EZ for LPD SHOP WITH A COP INC

Field Data
EIN 46-4198419
Case Number EO-2015044-000144
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LPD SHOP WITH A COP INC
Organization’s Mailing Address 50 S MULBERRY
City LOGAN
State OH
ZIP 43138
Accounting period End 12
Primary contact name DAN CAMPBELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DAN CAMPBELL
PRESIDENT AND DIRECTOR
34818 MOORE ROAD
LOGAN OH 43138

Officer/Director/Trustee Two

JERRY MELLINGER
VICE PRESIDENT AND DIRECTOR
30537 LAKE LOGAN ROAD
LOGAN OH 43138

Officer/Director/Trustee Three

ANTHONY BYRAM
SECRETARY TREASURER AND DIRECTOR
14520 MOLHER
LOGAN OH 43138

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/21/2013
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 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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