FORM 1023-EZ for SOUTH CENTRAL INDIANA BLUES SOCIETYINC

Field Data
EIN 47-4620797
Case Number EO-2015246-000339
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SOUTH CENTRAL INDIANA BLUES SOCIETYINC
Organization’s Mailing Address 4244 STATE ROAD 46 W
City NASHVILLE
State IN
ZIP 47448
Accounting period End 12
Primary contact name NANCY GAYLORD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NANCY GAYLORD
PRESIDENT, TREASURER
4244 STATE ROAD 46 W
NASHVILLE IN 47448

Officer/Director/Trustee Two

NEELY DRUIN
SECRETARY
508 S CORY LN
BLOOMINGTON IN 47403

Officer/Director/Trustee Three

ROY JUSTICE
DIRECTOR SOCIAL MEDIA
1183 LAWSON RD
BLOOMINGTON IN 47404

Officer/Director/Trustee Four

TIM REMMY
DIRECTOR MARKETING
2616 LEONARD SPRINGS RD
BLOOMINGTON IN 47403

Officer/Director/Trustee Five

JEFF SHEW
DIRECTOR EVENT COORDINATION
3132 N VALLEYVIEW DR
BLOOMINGTON IN 47404

Organization’s website WWW.SCIBLUES.ORG
Organization’s email INFO@SCIBLUES.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/14/2015
Organization Incorporation State IN
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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