FORM 1023-EZ for THOMAS M DUCKWORTH FOUNDATION

Field Data
EIN 83-1570419
Case Number EO-2018229-000296
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THOMAS M DUCKWORTH FOUNDATION
Organization’s Mailing Address 8212 GRISWOLD DR
City NEW ALBANY
State OH
ZIP 43054
Accounting period End 12
Primary contact name KELLY KANTOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLY KANTOR
FOUNDER
8212 GRISWOLD DR
NEW ALBANY OH 43054

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/14/18
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H30 - Cancer Research
Organization’s purpose Charitable: No
Religious: No
Educational: No
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KELLY KANTOR
Signature Title FOUNDER
Signature Date 8/14/18

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