FORM 1023-EZ for APPLE VALLEY SUPPORT GROUP

Field Data
EIN 37-1816958
Case Number EO-2017107-000216
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name APPLE VALLEY SUPPORT GROUP
Organization’s Mailing Address 472 BALDWIN DRIVE
City HOWARD
State OH
ZIP 43028
Accounting period End 12
Primary contact name ERIC LAZEAR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BOBBIE MEECHAN
OFFICER
72 BALDWIN DRIVE
HOWARD OH 43028

Officer/Director/Trustee Two

DENISE WELLMAN
OFFICER
974 KINGSWAY DRIVE
HOWARD OH 43028

Officer/Director/Trustee Three

ERIC LAZEAR
OFFICER
584 BALDWIN HEIGHTS CIRCLE
HOWARD OH 43028

Organization’s website
Organization’s email ELAPPLEVALLEY@YAHOO.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/7/2016
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P12 - Fund Raising and/or Fund Distribution
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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