FORM 1023-EZ for COLUMBUS YOUTH DEVELOPMENT ASSOCIATION

Field Data
EIN 47-2195545
Case Number EO-2015124-000163
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COLUMBUS YOUTH DEVELOPMENT ASSOCIATION
Organization’s Mailing Address 5607 JEFFERIES COURT
City WESTERVILLE
State OH
ZIP 43082
Accounting period End 12
Primary contact name KIMBERLY HACKLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BLAKE O HACKLER
PRESIDENT
5607 JEFFERIES COURT
WESTERVILLE OH 43082

Officer/Director/Trustee Two

KIMBERLY S HACKLER
TREASURER
5607 JEFFERIES COURT
WESTERVILLE OH 43082

Officer/Director/Trustee Three

ROBERT S GIULIANI
CO VICE-PRESIDENT
5031 RED BANK ROAD
GALENA OH 43021

Officer/Director/Trustee Four

CHRISTOPHER BAUERMEISTER
SECRETARY
3610 HICKORY ROCK DRIVE
POWELL OH 43065

Officer/Director/Trustee Five

AARON W WILBURN
CO VICE PRESIDENT
35 LONGITUDE DRIVE
MOUNT VERNON OH 43050

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/2/2015
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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
Signature Title
Signature Date

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