FORM 1023-EZ for BUTCH ELLIS FOUNDATION INC

Field Data
EIN 47-3281836
Case Number EO-2015176-000449
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BUTCH ELLIS FOUNDATION INC
Organization’s Mailing Address PO BOX 26
City MORRISTOWN
State IN
ZIP 46161-0026
Accounting period End 12
Primary contact name MATTHEW RYAN WORTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MATTHEW WORTON
DIRECTOR
PO BOX 26
MORRISTOWN IN 46161-0026

Officer/Director/Trustee Two

VICKIE ROBERTS
VICE PRESIDENT
PO BOX 26
MORRISTOWN IN 46161-0026

Officer/Director/Trustee Three

TAMMY WORTON
TREASURER
PO BOX 26
MORRISTOWN IN 46161-0026

Organization’s website HTTP://WWW.BUTCHELLISFOUNDATION.ORG/
Organization’s email MATTWORTON@BUTCHELLISFOUNDATION.ORG
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/3/2014
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O12 - 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 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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