FORM 1023-EZ for MACKEY FAMILY CHILDRENS CANCER FOUNDATION

Field Data
EIN 47-2398075
Case Number EO-2015149-000349
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MACKEY FAMILY CHILDRENS CANCER FOUNDATION
Organization’s Mailing Address 658 MAIN STREET
City LAFAYETTE
State IN
ZIP 47901
Accounting period End 12
Primary contact name JOSEPH W MACKEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOSEPH MACKEY
OFFICER
5313 HERITAGE DR
LAFAYETTE IN 47905

Officer/Director/Trustee Two

TAMARA MACKEY
OFFICER
5313 HERITAGE DR
LAFAYETTE IN 47905

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/24/2014
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G30 - Cancer
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 Yes
One Third Support Gifts No
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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