FORM 1023-EZ for BROWNSBURG OLDER ADULT ALLIANCE INC

Field Data
EIN 81-2740153
Case Number EO-2017053-000134
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BROWNSBURG OLDER ADULT ALLIANCE INC
Organization’s Mailing Address PO BOX 475
City BRONWSBURG
State IN
ZIP 46112-0475
Accounting period End 5
Primary contact name JENNIFER COX
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNIFER COX
PRESIDENT
10473 N COUNTY
BROWNSBURG IN 46112-9679

Officer/Director/Trustee Two

DONNA STOUT
TREASURER
187 SYCAMORE ST
BROWNSBURG IN 46112-1839

Officer/Director/Trustee Three

NANCI SLAGLE
SECRETARY
6493 WINGS CT
BROWNSBURG IN 46112-8611

Officer/Director/Trustee Four

SHIRLEY REAGAN
GENERAL BOARD MEMBER
4318 CLIFFORD ROAD
BROWNSBURG IN 46112-8533

Organization’s website WWW.BBURGOAA.ORG
Organization’s email INFO@BBURGOAA.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/23/2016
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P81 - Senior Centers, Services
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 Yes
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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