FORM 1023-EZ for CARROLL COUNTY HEARTLAND AQUATICS

Field Data
EIN 83-3999995
Case Number EO-2019333-000257
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CARROLL COUNTY HEARTLAND AQUATICS
Organization’s Mailing Address 201 HERITAGE DRIVE
City DELPHI
State IN
ZIP 46923
Accounting period End 12
Primary contact name JOSHUA HOWARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSHUA HOWARD
PRESIDENT
1170 S 800 W
DELPHI IN 46923

Officer/Director/Trustee Two

BRANDON MAXWELL
VICE PRESIDENT
1410 N DEER MEADOWS RD
DELPHI IN 46923

Officer/Director/Trustee Three

SANDRA BUSHMAN
SECRETARY
2605 W 300 N
CAMDEN IN 46917

Officer/Director/Trustee Four

MINDY SCHLOTMAN
TREASURER
8175 W 100 N
DELPHI IN 46923

Organization’s website HTTPS://WWW.TEAMUNIFY.COM/TEAM/INCCHA/PAGE/HOME
Organization’s email CCHEARTLANDAQUATICS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/13/19
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N67 - Swimming, Water Recreation
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 JOSHUA HOWARD
Signature Title PRESIDENT
Signature Date 11/27/19

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