FORM 1023-EZ for SHUT-OUT DIABETES INC

Field Data
EIN 81-5411142
Case Number EO-2019316-000253
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHUT-OUT DIABETES INC
Organization’s Mailing Address 232 BACH ROAD
City SCHERERVILLE
State IN
ZIP 46375
Accounting period End 12
Primary contact name DONALD HILLEGONDS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DONALD HILLEGONDS
PRESIDENT/SECRETARY
232 BACH ROAD
SCHERERVILLE IN 46375

Organization’s website SHUTOUTDIABETES.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/20/17
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E12 - Fund Raising and/or Fund Distribution
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 Yes
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 DONALD HILLEGONDS
Signature Title PRESIDENT/SECRETARY
Signature Date 11/8/19

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