FORM 1023-EZ for BLACKFORD INITIATIVE INC

Field Data
EIN 84-3403203
Case Number EO-2019301-000319
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACKFORD INITIATIVE INC
Organization’s Mailing Address 5671 N 100 E
City HARTFORD CITY
State IN
ZIP 47348-9230
Accounting period End 12
Primary contact name JON CREEK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JON CREEK
PRESIDENT
5671 N 100 E
HARTFORD CITY IN 47348-9230

Officer/Director/Trustee Two

PATRICIA REDMOND
TREASURER
1576 E 075 S
HARTFORD CITY IN 47348

Officer/Director/Trustee Three

DAVID BOWMAN
DIRECTOR
513 MAYFAIR LANE
HARTFORD CITY IN 47348

Officer/Director/Trustee Four

RUTH JENNERJAHN
DIRECTOR
413 WESTWOOD DRIVE
HARTFORD CITY IN 47348

Officer/Director/Trustee Five

RON BRANSON
DIRECTOR
55 CLUBVIEW DRIVE
HARTFORD CITY IN 47348

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/4/19
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
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 JON CREEK
Signature Title PRESIDENT
Signature Date 10/18/19

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