FORM 1023-EZ for TRI-STATE SLEEP SOCIETY INC

Field Data
EIN 84-3332694
Case Number EO-2020209-000560
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TRI-STATE SLEEP SOCIETY INC
Organization’s Mailing Address 411 CARROLL ROAD
City SOUTH WHITLEY
State IN
ZIP 46787
Accounting period End 12
Primary contact name MAIRE MENGERINK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MAIRE MENGERINK
PRESIDENT
411 CARROLL ROAD
SOUTH WHITLEY IN 46787

Officer/Director/Trustee Two

MARTIN KARDOS
VICE-PRESIDENT
411 CARROLL ROAD
SOUTH WHITLEY IN 46787

Officer/Director/Trustee Three

JODI KAHLENBECK
SECRETARY/TREASURER
411 CARROLL ROAD
SOUTH WHITLEY IN 46787

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/10/2019
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G03 - Professional Societies, Associations
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 MAIRE MENGERINK
Signature Title PRESIDENT
Signature Date 7/20/2020

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