FORM 1023-EZ for NICK WILLARD LIVE AGAIN FOUNDATION
| Field | Data |
|---|---|
| EIN | 83-3216659 |
| Case Number | EO-2019036-000806 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | NICK WILLARD LIVE AGAIN FOUNDATION |
| Organization’s Mailing Address | 50890 PINE MEADOWS CT |
| City | GRANGER |
| State | IN |
| ZIP | 46530 |
| Accounting period End | 1 |
| Primary contact name | DEBORAH CAMPITI |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
DEBORAH CAMPITI
BOARD DIRECTOR
50890 PINE MEADOWS CT
GRANGER IN 46530
Officer/Director/Trustee Two
PAIGE SALAMON
BOARD MEMBER
19758 KERN RD
SOUTH BEND IN 46614
Officer/Director/Trustee Three
MADELINE HASKINS
BORAD MEMBER
1954 AIRPORT RD SUITE 121
CHAMBLEE GA 30341
Officer/Director/Trustee Four
VINCENT CAMPITI
BOARD MEMBER
5771 OAKLAND TERRACE
INDIANAPOLIS IN 46220
Officer/Director/Trustee Five
ERIC GONZALEZ-TABLADA
BOARD MEMBER
1954 AIRPORT RD SUITE 121
CHABLEE GA 30341
| Organization’s website | NICKWILLARDLIVEAGAINLCOM |
|---|---|
| Organization’s email | NICKWILLARDLIVEAGAIN@PROTONMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/16/19 |
| Organization Incorporation State | IN |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F12 - Fund Raising and/or Fund Distribution |
| 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 | Yes |
| 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 | DEBORAH CAMPITI |
| Signature Title | BOARD DIRECTOR |
| Signature Date | 1/21/19 |
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