FORM 1023-EZ for ADAMS BRAIN CHARITY

Field Data
EIN 86-2059051
Case Number EO-2021089-001241
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ADAMS BRAIN CHARITY
Organization’s Mailing Address 1905 WINTON AVE
City INDIANAPOLIS
State IN
ZIP 46224
Accounting period End 12
Primary contact name ADAM SWARTZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBIN CLARK
PRESIDENT
5532 HOLLISTER DR
INDIANAPOLIS IN 46224

Officer/Director/Trustee Two

MIKE CLARK
TREASURER
5532 HOLLISTER DR
INDIANAPOLIS IN 46224

Organization’s website
Organization’s email ADAMSBRAINCHARITY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/6/2021
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H96 - Neurology, Neuroscience Research
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 Yes
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ROBIN CLARK
Signature Title PRESIDENT
Signature Date 2/13/2021

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