FORM 1023-EZ for BACKWATER GARDENS LAKE MAINTENANCEASSN INC

Field Data
EIN 47-2628770
Case Number EO-2014365-000059
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BACKWATER GARDENS LAKE MAINTENANCEASSN INC
Organization’s Mailing Address 104 EMS W23 LANE
City NORTH WEBSTER
State IN
ZIP 46555
Accounting period End 12
Primary contact name GARY ZWIERZYNSKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GARY ZWIERZYNSKI
PRESIDENT
2120 KENSINGTON BLVD
FORT WAYNE IN 46805

Officer/Director/Trustee Two

LON MALLORY
VICE PRESIDENT
67 EMS W23 LANE
NORTH WEBSTER IN 46555

Officer/Director/Trustee Three

MARY MALLORY
SECRETARY/TREASURER
67 EMS W23 LANE
NORTH WEBSTER IN 46555

Organization’s website
Organization’s email GARYZWIERZYNSKI@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/16/2014
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C32 - Water Resource, Wetlands Conservation and Management
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: Yes
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
Signature Title
Signature Date

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