FORM 1023-EZ for KING FERRY FOOD PANTRY INC

Field Data
EIN 81-3506035
Case Number EO-2016251-000230
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KING FERRY FOOD PANTRY INC
Organization’s Mailing Address PO BOX 242
City KING FERRY
State NY
ZIP 13081-0242
Accounting period End 12
Primary contact name JAMES BURKETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES BURKETT
PRESIDENT AND DIRECTOR
405 MAIN STREET PO BOX 343
AURORA NY 13026

Officer/Director/Trustee Two

ELAINE MEYERS
VICE PRESIDENT AND DIRECTOR
1462 ATWATER ROAD
KING FERRY NY 13081

Officer/Director/Trustee Three

JOHN DENTES
TREASURER AND DIRECTOR
425 MAIN STREET
AURORA NY 13026

Officer/Director/Trustee Four

CARIN KOPP
SECRETARY AND DIRECTOR
1181 CLEARVIEW ROAD
KING FERRY NY 13081

Officer/Director/Trustee Five

GAY FOLTS
DIRECTOR
8736 ROUTE 90 PO BOX 296
KING FERRY NY 13081

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/8/2016
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K31 - Food Banks, Food Pantries
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 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 Yes
One Third Support Gifts No
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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