FORM 1023-EZ for KSEA-IN INC

Field Data
EIN 47-2120161
Case Number EO-2017097-000323
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KSEA-IN INC
Organization’s Mailing Address 3442 STELLHORN ROAD
City FORT WAYNE
State IN
ZIP 46815
Accounting period End 6
Primary contact name DR JOHN LEE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN LEE
DIRECTOR AND PRESIDENT
723 W MICHIGAN ST SL 160
INDIANAPOLIS IN 46202-5132

Officer/Director/Trustee Two

CHURNTECH PARK
DIRECTOR/VP/TREASURER
3442 STELLHORN ROAD
FORT WAYNE IN 46815

Officer/Director/Trustee Three

NAKYEN CHOY
DIRECTOR AND SECRETARY
14480 LIVINGSTON LANE
CARMEL IN 46074

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/10/2017
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code U03 - Professional Societies, Associations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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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