FORM 1023-EZ for SOUTHWESTERN INDIANA CITIZENS FOR QUALITY OF LIFE INC

Field Data
EIN 83-0975824
Case Number EO-2020083-000509
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUTHWESTERN INDIANA CITIZENS FOR QUALITY OF LIFE INC
Organization’s Mailing Address PO BOX 111
City DALE
State IN
ZIP 47523
Accounting period End 12
Primary contact name JANE SCHIPP
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARY HESS
PRESIDENT
PO BOX 111
DALE IN 47523

Officer/Director/Trustee Two

RANDELL VAAL
FIRST VP
422 W PRANCER DRIVE N
SANTA CLAUS IN 47579

Officer/Director/Trustee Three

ROCK EMMERT
SECOND VICE-PRESIDENT
6431 E 700 S
FERDINAND IN 47579

Officer/Director/Trustee Four

JANE SCHIPP
SECRETARY/TREASURER
76 W MELCHOIR DR N
SANTA CLAUS IN 47579

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/19/2018
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C99 - Environmental Quality, Protection, and Beautification N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: Yes
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 JANE SCHIPP
Signature Title SECRETARY/TREASURER
Signature Date 3/21/2020

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