| Field | Data |
|---|---|
| EIN | 84-2761035 |
| Case Number | EO-2019262-000176 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | SHELBY INTERNATIONAL DENTAL OUTREACH LIMITED |
| Organization’s Mailing Address | 3965 BEAM RD |
| City | CRESTLINE |
| State | OH |
| ZIP | 44827 |
| Accounting period End | 12 |
| Primary contact name | MARISSA MILLER |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
MARISSA MILLER
PRESIDENT
3965 BEAM RD
CRESTLINE OH 44827
AMANDA MILLER
TREASURER
16 1/2 MONROE AVE
SHELBY OH 44875
PATRICK SHIRA
CHAIRPERSON OF THE GOVERNING BODY
3965 BEAM RD
CRESTLINE OH 44827
LORI CLINE
TRUSTEE
100 W MAIN ST
SHELBY OH 44875
PHILLIP FONTES
TRUSTEE
100 W MAIN ST
SHELBY OH 44875
| Organization’s website | |
|---|---|
| Organization’s email | OPERCELLO@YAHOO.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 8/13/19 |
| Organization Incorporation State | OH |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E30 - Health Treatment Facilities, Primarily Outpatient |
| 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 | Yes |
| 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 | MARISSA MILLER |
| Signature Title | PRESIDENT |
| Signature Date | 9/17/19 |
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