FORM 1023-EZ for CHAMPION HOUSE INC

Field Data
EIN 75-3262767
Case Number EO-2016347-000296
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHAMPION HOUSE INC
Organization’s Mailing Address 7902 NEWLIN DRICE
City FORT WAYNE
State IN
ZIP 46816
Accounting period End 3
Primary contact name GILDA HOWARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GILDA HOWARD
PRESIDENT/TREASURER
7902 NEWLIN DRIVE
FORT WAYNE IN 46816

Officer/Director/Trustee Two

GARY HOWARD
VICE PRESIDENT
7902 NEWLIN DRIVE
FORT WAYNE IN 46816

Officer/Director/Trustee Three

ENDIA STEPHENS
SECRETARY
P O BOX 12974
HUNTERTOWN IN 46866

Officer/Director/Trustee Four

DEBORAH HOWARS
MEMBER
2424 CAPITOL AVENUE
FORT WAYNE IN 46816

Officer/Director/Trustee Five

WILMA HOOKS
MEMBER
218 W SUTTENFIELD AVE
FORT WAYNE IN 46807

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/27/2008
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P72 - Half-Way House (Short-Term Residential Care)
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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