FORM 1023-EZ for BELOVED INC

Field Data
EIN 32-0505611
Case Number EO-2017121-000114
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BELOVED INC
Organization’s Mailing Address 2633 GLENCAIRN DRIVE
City FORT WAYNE
State IN
ZIP 46815
Accounting period End 12
Primary contact name LORI TRAVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RACHEL BLACK
PRESIDENT, TREASURER, DIRECTOR
2633 GLENCAIRN DRIVE
FORT WAYNE IN 46815

Officer/Director/Trustee Two

LORI TRAVIS
VICE PRESIDENT, SECRETARY, DIRECTOR
13402 HOOSIER STREET
GRABILL IN 46741

Officer/Director/Trustee Three

ALISON ANDERSON
DIRECTOR
13402 HOOSIER STREET
GRABILL IN 46741

Organization’s website
Organization’s email EXTRAVAGANTLOVETODAY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/29/2016
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X99 - Religion Related, Spiritual Development N.E.C.
Organization’s purpose Charitable: No
Religious: Yes
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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