FORM 1023-EZ for VILLAGE IMPACT PROJECT

Field Data
EIN 84-2585825
Case Number EO-2019231-000337
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name VILLAGE IMPACT PROJECT
Organization’s Mailing Address 423 WEST LIMESTONE STREET
City YELLOW SPRINGS
State OH
ZIP 45387-1721
Accounting period End 12
Primary contact name DONNA HALLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDREW MILLER
PRESIDENT
1834 WOODBINE AVENUE APT 4
FAIRBORN OH 45324

Officer/Director/Trustee Two

MARIE HERTZLER
VICE-PRESIDENT
141 NORTH WALNUT STREET
YELLOW SPRINGS OH 45387

Officer/Director/Trustee Three

DAWN BOYER
TREASURER
4650 LAMONT DRIVE
YELLOW SPRINGS OH 45387

Officer/Director/Trustee Four

ERIC JOHNSON
SECRETARY
401 SOUTH HIGH STREET
YELLOW SPRINGS OH 45387

Officer/Director/Trustee Five

DALE HOTALING
DIRECTOR
229 PLEASANT STREET
YELLOW SPRINGS OH 45387

Organization’s website N/A
Organization’s email VILLAGEIMPACTPROJECT@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/19
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O30 - Adult, Child Matching Programs
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 ERIC JOHNSON
Signature Title SECRETARY
Signature Date 8/15/19

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