FORM 1023-EZ for GOOD SAMARITAN ADVOCATE

Field Data
EIN 84-2986473
Case Number EO-2019259-000457
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GOOD SAMARITAN ADVOCATE
Organization’s Mailing Address 657 N HIDDEN HARBOR DRIVE
City PORT CLINTON
State OH
ZIP 43452-3746
Accounting period End 12
Primary contact name PAULINE BASINGER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAULINE BASINGER
PRESIDENT
657 N HIDDEN HARBOR DRIVE
PORT CLINTON OH 43452-3746

Officer/Director/Trustee Two

RICK BASINGER
TREASURER
657 N HIDDEN HARBOR DRIVE
PORT CLINTON OH 43452-3746

Officer/Director/Trustee Three

FRANK RILEY
SECRETARY
657 N HIDDEN HARBOR DRIVE
PORT CLINTON OH 43452-3746

Organization’s website NA
Organization’s email GOODSAMARITANADVOCATE@MAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/5/19
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 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 PAULINE BASINGER
Signature Title PRESIDENT
Signature Date 9/10/19

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