FORM 1023-EZ for MYRTLE BUNDY TESTAMENTARY TRUST

Field Data
EIN 35-6401245
Case Number EO-2019039-000772
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MYRTLE BUNDY TESTAMENTARY TRUST
Organization’s Mailing Address 310 4TH ST
City COVINGTON
State IN
ZIP 47932
Accounting period End 12
Primary contact name RICHARD M HOLMES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICHARD HOLMES
TRUSTEE
310 4TH STREET
COVINGTON IN 47932

Officer/Director/Trustee Two

JOHN PATTON
TRUSTEE
9 WEST STATE STREET
KINGMAN IN 47952

Officer/Director/Trustee Three

GREG CLINGAN
TRUSTEE
404 LIBERTY ST
COVINGTON IN 47932

Organization’s website
Organization’s email
Organization Incorporated
Organization trust Yes
Necessary Organizing Documents Yes
Organization Incorporation Date 7/10/82
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E30 - Health Treatment Facilities, Primarily Outpatient
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name RICHARD HOLMES
Signature Title TRUSTEE
Signature Date 2/5/19

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