FORM 1023-EZ for SOCIAL IMPACT COLLEGE COACHING

Field Data
EIN 85-1219170
Case Number EO-2020196-000174
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOCIAL IMPACT COLLEGE COACHING
Organization’s Mailing Address 139 EAST LIMESTONE STREET
City YELLOW SPRINGS
State OH
ZIP 45387
Accounting period End 6
Primary contact name MATTHEW ROSSMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID BURGESS
PRESIDENT AND SECRETARY
139 EAST LIMESTONE STREET
YELLOW SPRINGS OH 45387

Officer/Director/Trustee Two

ANNETTE BADAMY
BOARD CHAIR AND TREASURER
139 EAST LIMESTONE STREET
YELLOW SPRINGS OH 45387

Officer/Director/Trustee Three

JASON AUGENSTEIN
DIRECTOR
139 EAST LIMESTONE STREET
YELLOW SPRINGS OH 45387

Officer/Director/Trustee Four

WILLIAM GRACIE
DIRECTOR
139 EAST LIMESTONE STREET
YELLOW SPRINGS OH 45387

Organization’s website HTTPS://WWW.SICCOACHING.ORG/
Organization’s email SICC@SICCOACHING.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/14/2020
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B90 - Educational Services and Schools - Other
Organization’s purpose Charitable: Yes
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 Yes
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 DAVID BURGESS
Signature Title PRESIDENT AND SECRETARY
Signature Date 6/11/2020

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