FORM 1023-EZ for LUBRIPLATE EMPLOYEE CHARITY FUND

Field Data
EIN 83-3987373
Case Number EO-2021099-001418
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LUBRIPLATE EMPLOYEE CHARITY FUND
Organization’s Mailing Address 1500 OAKDALE AVENUE
City TOLEDO
State OH
ZIP 43605-0038
Accounting period End 12
Primary contact name JACQUELYN KAY DUSZA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACQUELYN DUSZA
HONORARY OFFICER
1624 GRAND BAY DIVE
OREGON OH 43616

Officer/Director/Trustee Two

TRACY EPPARD
SECRETARY/TREASURER
1500 OAKDALE AVENUE
TOLEDO OH 43605-0038

Officer/Director/Trustee Three

TODD WILLIAMS
OFFICER
1500 OAKDALE AVENUE
TOLEDO OH 43605-0038

Officer/Director/Trustee Four

RUDOLPH AGOSTI
OFFICER
1500 OAKDALE AVENUE
TOLEDO OH 43605-0038

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/1/2020
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 JACQUELYN DUSZA
Signature Title HONORARY OFFICER
Signature Date 3/19/2021

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