FORM 1023-EZ for FATHER-TO-FATHER ENGAGEMENT PROGRAM

Field Data
EIN 84-3896746
Case Number EO-2019352-000094
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FATHER-TO-FATHER ENGAGEMENT PROGRAM
Organization’s Mailing Address 3420 N BROADWAY ST
City INDIANAPOLIS
State IN
ZIP 46204
Accounting period End 12
Primary contact name DEWAYNE KEEYLEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEWAYNE KEEYLEN
CHAIRMAN & CEO
3420 N BROADWAY ST
INDIANAPOLIS IN 46205

Officer/Director/Trustee Two

NADINA EDWARDS
PRESIDENT
3420 N BROADWAY ST
INDIANAPOLIS IN 46205

Officer/Director/Trustee Three

CAROLYN CURRIN-HOLDER
VICE PRESIDENT
3420 N BROADWAY ST
INDIANAPOLIS IN 46205

Officer/Director/Trustee Four

KENNETH THORPE
OFFICER
3420 N BROADWAY ST
INDIANAPOLIS IN 46205

Officer/Director/Trustee Five

KERRY NAGLE
OFFICER
3420 N BROADWAY ST
INDIANAPOLIS IN 46205

Organization’s website WWW.FATHERTOFATHERLLC.COM/
Organization’s email FATHER2FATHER2019@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/16/2019
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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 DEWAYNE KEEYLEN
Signature Title CHAIRMAN & CEO
Signature Date 12/16/2019

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