FORM 1023-EZ for SCREAM IN THE DARK FILM FESTIVAL INC

Field Data
EIN 46-4975393
Case Number EO-2015203-000282
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SCREAM IN THE DARK FILM FESTIVAL INC
Organization’s Mailing Address 15013 MORMON STREET
City BENNINGTON
State NE
ZIP 68007-1247
Accounting period End 12
Primary contact name KEN JOHNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KEN JOHNSON
PRESIDENT
15013 MORMON STREET
BENNINGTON NE 68007-1247

Officer/Director/Trustee Two

TIMOTHY WELCH
EXECUTIVE BOARD MEMBER
736 SOUTH 13TH STREET UNIT 31
BLAIR NE 68008-2112

Officer/Director/Trustee Three

PATRICK GRAVES
SECRETARY
7014 SOUTH 133RD CIRCLE
OMAHA NE 68138-6154

Officer/Director/Trustee Four

MICHAEL TAYLOR
TREASURER
33008 E PARK HIGHWAY BOX 87
SOUTH BEND NE 68058-4351

Officer/Director/Trustee Five

DAVID BOROWIAK
DIRECTOR
551 NORTH 77TH AVENUE
OMAHA NE 68114-3053

Organization’s website WWW.SCREAMINTHEDARKOMAHA.COM
Organization’s email KEN@SCREAMINTHEDARKOMAHA.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/19/2014
Organization Incorporation State NE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A31 - Film, Video
Organization’s purpose Charitable: Yes
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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