FORM 1023-EZ for DEBRA LYNN GROSS FOUNDATION INC

Field Data
EIN 85-1593225
Case Number EO-2020216-000355
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DEBRA LYNN GROSS FOUNDATION INC
Organization’s Mailing Address 622 W GUMP RD
City FORT WAYNE
State IN
ZIP 46845
Accounting period End 12
Primary contact name ZACHARY TAYLOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ZACHARY TAYLOR
DIRECTOR
622 W GUMP RD
FORT WAYNE IN 46845

Officer/Director/Trustee Two

RAEANN TAYLOR
DIRECTOR
622 W GUMP RD
FORT WAYNE IN 46845

Officer/Director/Trustee Three

ELLIOT TAYLOR
DIRECTOR
622 W GUMP RD
FORT WAYNE IN 46845

Organization’s website
Organization’s email DLYNNGROSSFOUNDATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/27/2020
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T22 - Private Independent Foundations
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ZACHARY TAYLOR
Signature Title DIRECTOR
Signature Date 7/30/2020

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