FORM 1023-EZ for SUPERCAMP INCORPORATED

Field Data
EIN 46-3738633
Case Number EO-2014279-000531
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SUPERCAMP INCORPORATED
Organization’s Mailing Address 6044 DIXON AVE
City TOLEDO
State OH
ZIP 43613-1204
Accounting period End 10
Primary contact name HELEN KOUROUS-HARRIGAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

HELEN KOUROUS-HARRIGAN
NONPROFIT CHAIR
653 BORGESS AVE
MONROE MI 48162

Officer/Director/Trustee Two

KATIE WATTS
BOARD PRESIDENT
1744 MARLOW
TOLEDO OH 43613

Officer/Director/Trustee Three

CINDY KOWALSKI
TREASURER
4920 OAK GLEN DR
TOLEDO OH 43613

Officer/Director/Trustee Four

EDITH DYKE
BOARD MEMBER
6044 DIXON AVE
TOLEDO OH 43613

Officer/Director/Trustee Five

ROBIN REIMER
BOARD MEMBER
294 MARGARET PL
PERRYSBURG OH 43551

Organization’s website WWW.SUPERCAMP.ORG
Organization’s email BLWSUPERCAMP@SUPERCAMP.ORG
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/1975
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: No
Religious: No
Educational: Yes
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
Signature Title
Signature Date

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