FORM 1023-EZ for CAREGIVER SHELTER FUND

Field Data
EIN 85-0693661
Case Number EO-2020106-000177
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CAREGIVER SHELTER FUND
Organization’s Mailing Address 970 JOE WALKER ROAD
City SUNBURY
State OH
ZIP 43074
Accounting period End 12
Primary contact name SEAN WHITTAKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSIAH MYERS
CEO
22 W 4TH AVENUE
COLUMBUS OH 43201

Officer/Director/Trustee Two

ROBERT MYERS
CHAIRMAN
970 JOE WALKER ROAD
SUNBURY OH 43074

Officer/Director/Trustee Three

CHRIS CHAPIN
CFO
10727 KELLER PINES COURT
GALENA OH 43021

Organization’s website WWW.CAREGIVERSHELTERFUND.ORG
Organization’s email JOSIAH@AIRRIVA.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/13/2020
Organization Incorporation State OH
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 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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JOSIAH MYERS
Signature Title CEO
Signature Date 4/13/2020

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