FORM 1023-EZ for OHIO RIVER VALLEY T1D

Field Data
EIN 81-5362987
Case Number EO-2017054-000350
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name OHIO RIVER VALLEY T1D
Organization’s Mailing Address 1702 DOGWOOD RIDGE RD
City WHEELERSBURG
State OH
ZIP 45694
Accounting period End 12
Primary contact name MALISSA SARVER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MALISSA SARVER
EXECUTIVE DIRECTOR
1702 DOGWOOD RIDGE RD
WHEELERSBURG OH 45694

Officer/Director/Trustee Two

KIM BROWN
DIRECTOR
1635 CLAIRMONT AVE
WHEELERSBURG OH 45694

Officer/Director/Trustee Three

STEVE SARVER
DIRECTOR
1702 DOGWOOD RIDGE RD
WHEELERSBURG OH 45694

Officer/Director/Trustee Four

TRACIE LEWIS
DIRECTOR
1533 FRANKIES LANE
PORTSMOUTH OH 45662

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/15/2017
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 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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