FORM 1023-EZ for DRAKE GOETZ MEMORIAL PARK INC

Field Data
EIN 83-1968599
Case Number EO-2018273-000057
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DRAKE GOETZ MEMORIAL PARK INC
Organization’s Mailing Address 4082 N 350 E
City HUNTINGTON
State IN
ZIP 46750
Accounting period End 12
Primary contact name DIANA MERTZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DIANA MERTZ
PRESIDENT
4334 N 350 E
HUNTINGTON IN 46750

Officer/Director/Trustee Two

SHELLI GOETZ
VICE PRESIDENT
1675 E 200 N
HUNTINGTON IN 46750

Officer/Director/Trustee Three

CAMILLE KLINE
SECY/TREASURER
3351 N 300 E
HUNTINGTON IN 46750

Officer/Director/Trustee Four

RONALD GOETZ II
DIRECTOR
2897 E 400 N
HUNTINGTON IN 46750

Officer/Director/Trustee Five

TODD LANDRUM
DIRECTOR
5132 N OLD FORT WAYNE RD
HUNTINGTON IN 46750

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/8/18
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N32 - Parks and Playgrounds
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 DIANA MERTZ
Signature Title PRESIDENT
Signature Date 9/26/18

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