FORM 1023-EZ for THE CISSELL FAMILY CHARITABLE FOUNDATION

Field Data
EIN 81-4721684
Case Number EO-2017054-000300
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE CISSELL FAMILY CHARITABLE FOUNDATION
Organization’s Mailing Address 4750 S RAEBURN DRIVE
City CINCINNATI
State OH
ZIP 45223
Accounting period End 12
Primary contact name JAMES CISSELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES CISSELL
PRESIDENT
4750 S RAEBURN DRIVE
CINCINNATI OH 45223

Officer/Director/Trustee Two

CAROLYN FORD
TRUSTEE
4750 RAEBURN DRIVE
CINCINNATI OH 45223

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/30/2016
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T22 - Private Independent Foundations
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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