FORM 1023-EZ for PUSH ATHLETES BREAKING BARRIERS

Field Data
EIN 85-2985138
Case Number EO-2020267-000375
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PUSH ATHLETES BREAKING BARRIERS
Organization’s Mailing Address 11330 WEST COUNTY ROAD 400 SOUTH
City YORKTOWN
State IN
ZIP 47396
Accounting period End 12
Primary contact name JULIA WHITE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LANCE OTTINGER
PRESIDENT
4209 W LAUREL OAK LANE
MUNCIE IN 47304

Officer/Director/Trustee Two

JULIA WHITE
SECRETARY
11330 WEST COUNTY ROAD 400 SOUTH
YORKTOWN IN 47396

Officer/Director/Trustee Three

LARRY OTTINGER
MEMBER
801 SOUTH REGAL COURT
MUNCIE IN 47304

Officer/Director/Trustee Four

JANET MCKIBBEN
MEMBER
5722 SOUTH FABI DRIVE
MUNCIE IN 47302

Officer/Director/Trustee Five

SCOTT TAYLOR
MEMBER
7008 WEST SANTA FE DRIVE
MUNCIE IN 47304

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/6/2020
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JULIA WHITE
Signature Title SECRETARY
Signature Date 9/21/2020

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