FORM 1023-EZ for SHERIFFS COMMUNITY IMPACT PROGRAM

Field Data
EIN 83-3030483
Case Number EO-2019284-000339
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHERIFFS COMMUNITY IMPACT PROGRAM
Organization’s Mailing Address 310 E MAIN STREET
City LOUISA
State KY
ZIP 41230-1159
Accounting period End 12
Primary contact name JOE D WOJTOWICZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHUCK JACKSON
OFFICER
310 E MAIN STREET
LOUISA KY 41230-1159

Officer/Director/Trustee Two

JOSEPH WOJTOWICZ
ASSOCIATE
310 E MAIN STREET
LOUISA KY 41230-1159

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/7/19
Organization Incorporation State KY
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 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 CHUCK JACKSON
Signature Title OFFICER
Signature Date 10/8/19

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