FORM 1023-EZ for CLUB INNERVISION INC

Field Data
EIN 83-4687571
Case Number EO-2019197-000113
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CLUB INNERVISION INC
Organization’s Mailing Address 8060 HOLLOW CREEK CT
City INDIANAPOLIS
State IN
ZIP 46268-1738
Accounting period End 12
Primary contact name JEFTY SULTZER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEFTY SULTZER
PRESIDENT
8060 HOLLOW CREEK CT
INDIANAPOLIS IN 46268-1738

Officer/Director/Trustee Two

AARON PINNER
VICE PRESIDENT
11418 LONG LAKE DR
INDIANAPOLIS IN 46235-6138

Officer/Director/Trustee Three

ROBERT JONES
SECRETARY
5451 E 42ND STREET
INDIANAPOLIS IN 46226-4706

Officer/Director/Trustee Four

GARLAND BOONE
TREASURER
2025 KOEHNE ST
INDIANAPOLIS IN 46202-1041

Officer/Director/Trustee Five

DAVID PEARSON
SERGEANT AT ARMS
4514 SHADY LANE
INDIANAPOLIS IN 46226-3348

Organization’s website
Organization’s email ROBERTKJ2@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/28/17
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 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 ROBERT JONES
Signature Title SECRETARY
Signature Date 7/12/19

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