FORM 1023-EZ for TERRYS SECOND CHANCE

Field Data
EIN 47-1670724
Case Number EO-2014261-000484
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TERRYS SECOND CHANCE
Organization’s Mailing Address 4103 MINERS WAY
City SELLERSBURG
State IN
ZIP 47172
Accounting period End 9
Primary contact name CHELSEY HACKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHELSEY HACKER
PRESIDENT
4103 MINERS WAY
SELLERSBURG IN 47172

Officer/Director/Trustee Two

MICHAEL HACKER
VICE-PRESIDENT
4103 MINERS WAY
SELLERSBURG IN 47172

Officer/Director/Trustee Three

CAROLYNN HENSGEN
VICE-PRESIDENT
3321 COOPERS LANE
SELLERSBURG IN 47172

Organization’s website WWW.FACEBOOK.COM/HELPTERRYWALK
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/6/2014
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W11 - Single Organization Support
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 Yes
One Third Support Gifts No
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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