FORM 1023-EZ for PEDIATRIC CORTICAL VISUAL IMPAIRMENT SOCIETY INC
| Field | Data |
|---|---|
| EIN | 47-1752181 |
| Case Number | EO-2019254-000271 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | PEDIATRIC CORTICAL VISUAL IMPAIRMENT SOCIETY INC |
| Organization’s Mailing Address | 4257 N 140TH ST |
| City | OMAHA |
| State | NE |
| ZIP | 68164 |
| Accounting period End | 12 |
| Primary contact name | DONALD P BUSH CPA |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
SARA OLSEN
DIRECTOR
4257 N 140 ST
OMAHA NE 68164
Officer/Director/Trustee Two
RICHARD LEGGE
BOARD MEMBER
6156 WESTERN AVE
OMAHA NE 68132
Officer/Director/Trustee Three
CULLEN WAUGH
BOARD MEMBER
1136 KINGS RIDGE
WADSWORTH OH 44281
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/1/16 |
| Organization Incorporation State | NE |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | G01 - Alliance/Advocacy Organizations |
| 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 | Yes |
| 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 | Yes |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | SARA OLSEN |
| Signature Title | DIRECTOR |
| Signature Date | 9/9/19 |
| EIN | 47-1752181 |
| Case Number | EO-2015365-000256 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | PEDIATRIC CORTICAL VISUAL IMPAIRMENT SOCIETY INC |
| Organization’s Mailing Address | 7810 DAVENPORT STREET |
| City | OMAHA |
| State | NE |
| ZIP | 68114 |
| Accounting period End | 12 |
| Primary contact name | RICHARD LEGGE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
Officer/Director/Trustee One
RICHARD LEGGE
PRESIDENT
7810 DAVENPORT
OMAHA NE 68114
Officer/Director/Trustee Two
SARA OLSEN
SECRETARY
4257 N 140TH STREET
OMAHA NE 68164
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/13/2015 |
| Organization Incorporation State | NE |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | B03 - Professional Societies, Associations |
| 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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