FORM 1023-EZ for AMPS4OHIO INC

Field Data
EIN 81-2350716
Case Number EO-2016256-000467
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AMPS4OHIO INC
Organization’s Mailing Address 6071 BERNICE ST
City AMANDA
State OH
ZIP 43102-9505
Accounting period End 12
Primary contact name JUANITA MENGEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JUANITA MENGEL
PRESIDENT
6071 BERNICE ST SW
AMANDA OH 43102-9505

Officer/Director/Trustee Two

EDWARD VANASDALE
VICE PRESIDENT
5290 REDWOOD RD
COLUMBUS OH 43229-4481

Officer/Director/Trustee Three

LINDA PRATT
SECRETARY
468 SHELL CT W
WHITEHALL OH 43212-2072

Officer/Director/Trustee Four

GRANT LEWIS
TREASURER
216 APPLEWOOD DR
PATASKALA OH 43062-7854

Organization’s website WWW.AMPS4OHIO.COM
Organization’s email AMPS4OHIO@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/19/2016
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E86 - Patient Services - Entertainment, Recreation
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 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
Signature Title
Signature Date

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