FORM 1023-EZ for COMMUNITY INCLUSION AMBASSADORS INC
| Field | Data |
|---|---|
| EIN | 84-4540868 |
| Case Number | EO-2020071-000268 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | COMMUNITY INCLUSION AMBASSADORS INC |
| Organization’s Mailing Address | 126 W CHARLES STREET |
| City | PAOLI |
| State | IN |
| ZIP | 47454 |
| Accounting period End | 12 |
| Primary contact name | PATRICK C UNDERWOOD |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
PATRICK UNDERWOOD
PRESIDENT
868 S HANCOCK STREET
PAOLI IN 47454
Officer/Director/Trustee Two
MICHELLE MOON
VICE-PRESIDENT
209 FAIR STREET
PAOLI IN 47454
Officer/Director/Trustee Three
ASHELY WALTON
SECRETARY
3510 SOUTH COUNTY ROAD 250 EAST
PAOLI IN 47454
Officer/Director/Trustee Four
JENETTA UNDERWOOD
TREASURY
126 W CHARLES STREET
PAOLI IN 47454
Officer/Director/Trustee Five
KYMARI KINSEY
BOARD MEMBER
1997 DOE VALLEY CT
PAOLI IN 47454
| Organization’s website | |
|---|---|
| Organization’s email | ORANGE.CO.CIA@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/31/2020 |
| Organization Incorporation State | IN |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P80 - Services to Promote the Independence of Specific Populations |
| Organization’s purpose | Charitable: Yes Religious: No Educational: No Scientific: No Literary: No Public Safety: No Amateur Sports: No Cruelty Prevention: Yes |
| 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 | PATRICK UNDERWOOD |
| Signature Title | PRESIDENT |
| Signature Date | 3/9/2020 |
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