FORM 1023-EZ for INDIANA LUTHERAN SCHOOLS ATHLETIC ASSOCIATION INC

Field Data
EIN 47-1688480
Case Number EO-2014251-000601
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name INDIANA LUTHERAN SCHOOLS ATHLETIC ASSOCIATION INC
Organization’s Mailing Address 1601 ST JOE RIVER DRIVE
City FORT WAYNE
State IN
ZIP 46805
Accounting period End 12
Primary contact name MARK MUEHL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARK MUEHL
PRESIDENT
1601 ST JOE RIVER DRIVE
FORT WAYNE IN 46805

Officer/Director/Trustee Two

WALT MISCHNICK
VICE PRESIDENT
26360 SCOTCH PINE TRAIL
SOUTH BEND IN 46619

Officer/Director/Trustee Three

DAWN SCHULTZ
SECRETARY TREASURER
6111 SHELBY STREET
INDIANAPOLIS IN 46227

Officer/Director/Trustee Four

MARK RUDZINSKI
AT-LARGE
520 S CHESTNUT
SEYMOUR IN 47274

Officer/Director/Trustee Five

TIM FALKENSTERN
COMMISSIONER
13716 SPLIT ROCK COVE
FORT WAYNE IN 46845

Organization’s website
Organization’s email INDIANALSAA@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/9/2014
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B20 - Elementary, Secondary Education, K - 12
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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
Signature Title
Signature Date

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