FORM 1023-EZ for AETNA MANOR REVITALIZATION PROGRAM

Field Data
EIN 82-0906225
Case Number EO-2018190-000544
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AETNA MANOR REVITALIZATION PROGRAM
Organization’s Mailing Address 4449 E 13TH AVE
City GARY
State IN
ZIP 46403-3654
Accounting period End 12
Primary contact name PENELOPE LOVE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PENELOPE LOVE
CEO/PRESIDENT
4449 E 13TH AVE
GARY IN 46403-3456

Officer/Director/Trustee Two

EDDIE TARVER
TREASURER
1348 BENTON ST
GARY IN 46403

Officer/Director/Trustee Three

ARTAY IVEY
SECRETARY
4332 E 13TH AVE
GARY IN 46403-3652

Organization’s website WWW.AETNAMANOR@SIMPLESITE.COM
Organization’s email AMRP2014@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/17/18
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name PENELOPE LOVE
Signature Title CEO/PRESIDENT
Signature Date 7/6/18

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