FORM 1023-EZ for FORD WILSON RACING CHAMPIONS INC

Field Data
EIN 47-4983216
Case Number EO-2015251-000404
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FORD WILSON RACING CHAMPIONS INC
Organization’s Mailing Address 3550 SEDGEMOOR CIRCLE
City CARMEL
State IN
ZIP 46032
Accounting period End 12
Primary contact name PATRICK CROCKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MATTHEW LACY
PRESIDENT/BOARD
3550 SEDGEMOOR
CARMEL IN 46032

Officer/Director/Trustee Two

PATRICK CROCKER
SECRETARY/BOARD
107 W MICHIGAN 4TH FL
KALAMAZOO MI 49007

Officer/Director/Trustee Three

KASEY WAKEFIELD
TREASURER/BOARD
4800 W 96TH STREET
INDIANAPOLIS IN 46268

Officer/Director/Trustee Four

BRUCE ADKINS
BOARD MEMBER
410 E NOBLE
LEBANON IN 46052

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/14/2015
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N72 - Special Olympics
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
Signature Title
Signature Date

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