FORM 1023-EZ for BETA SIGMA PHI THETA NU CHAPTER

Field Data
EIN 47-4876950
Case Number EO-2015239-000160
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BETA SIGMA PHI THETA NU CHAPTER
Organization’s Mailing Address 3637 E CO RD 1200N
City BATESVILLE
State IN
ZIP 47006
Accounting period End 12
Primary contact name DIANE FULLENKAMP
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAN PRICKEL
PRESIDENT
27101 SR 46W
BATESVILLE IN 47006

Officer/Director/Trustee Two

DIANE FULLENKAMP
VP
3637 E CR 1200N
BATESVILLE IN 47006

Officer/Director/Trustee Three

ANNE BARAN
SECRETARY
13530 N CR 400E
BATESVILLE IN 47006

Officer/Director/Trustee Four

JANICE BROUGHER
TREASURER
87 DIRKS RD
BATESVILLE IN 47006

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/1/1963
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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
Signature Title
Signature Date

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