FORM 1023-EZ for SULLIVAN COUNTY CIVIC FOUNDATION

Field Data
EIN 86-1929206
Case Number EO-2021090-000797
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SULLIVAN COUNTY CIVIC FOUNDATION
Organization’s Mailing Address 8262 E CENTER ROAD
City SULLIVAN
State IN
ZIP 47882
Accounting period End 6
Primary contact name DEBORAH ELLIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRISTOPHER GENTRY
PRESIDENT
3393 N WINDY RIDGE DR
SULLIVAN IN 47882

Officer/Director/Trustee Two

KATHY CROCK
SECRETARY
1285 E COUNTY RD 3 SE
CARLISLE IN 47838

Officer/Director/Trustee Three

DEBORAH ELLIS
TREASURER
8262 E CENTER ROAD
SULLIVAN IN 47882

Officer/Director/Trustee Four

JOHN DELPH
COMMUNITY DIRECTOR
8234 E CLARK ST
DUGGER IN 47848

Officer/Director/Trustee Five

TAMMY DELPH
COMMUNITY DIRECTOR
8234 E CLARK ST
DUGGER IN 47848

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/18/2021
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - 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 DEBORAH ELLIS
Signature Title TREASURER
Signature Date 2/18/2021

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