FORM 1023-EZ for THE WHOLESOME PANTRY NONPROFIT CORPORATION

Field Data
EIN 84-4585954
Case Number EO-2020111-000074
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE WHOLESOME PANTRY NONPROFIT CORPORATION
Organization’s Mailing Address 9920 MAIN ST 542
City BOTHELL
State WA
ZIP 98011-3565
Accounting period End 12
Primary contact name PHILLIP SHAFFER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PHILLIP SHAFFER
PRESIDENT/TREASURER
9920 MAIN ST 542
BOTHELL WA 98011-3565

Officer/Director/Trustee Two

NANCY SHAFFER
DIRECTOR/SECRETARY
9920 MAIN ST 542
BOTHELL WA 98011-3565

Organization’s website
Organization’s email NANCY.WHOLESOMEPANTRY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/23/2020
Organization Incorporation State WA
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 Yes
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 PHILLIP SHAFFER
Signature Title PRESIDENT/TREASURER
Signature Date 4/16/2020

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