FORM 1023-EZ for KANSAS AMPUTEE SUPPORT SYSTEM

Field Data
EIN 47-4920744
Case Number EO-2019233-000283
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KANSAS AMPUTEE SUPPORT SYSTEM
Organization’s Mailing Address 3401 MONA ST
City HUTCHINSON
State KS
ZIP 67502
Accounting period End 8
Primary contact name MARCIA BROWN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PHYLLIS SWANK
OFFICER
3401 MONA ST
HUTCHINSON KS 67502

Officer/Director/Trustee Two

MARCIA BROWN
TREASURER
16514 S OLD STAGE RD
PRETTY PRAIRIE KS 67570-8629

Officer/Director/Trustee Three

FARROL BROWN
OFFICER
16514 S OLD STAGE RD
PRETTY PRAIRIE KS 67570-8629

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/28/15
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E11 - Single Organization Support
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 Yes
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 MARCIA BROWN
Signature Title TREASURER
Signature Date 8/19/19
EIN 47-4920744
Case Number EO-2017037-000362
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KANSAS AMPUTEE SUPPORT SYSTEM
Organization’s Mailing Address 3401 MONA ST
City HUTCHINSON
State KS
ZIP 67502
Accounting period End 8
Primary contact name MARCIA BROWN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PHYLLIS SWANK
OFFICER
3401 MONA ST
HUTCHINSON KS 67502

Officer/Director/Trustee Two

MARCIA BROWN
TREASURER
16514 S OLD STAGE RD
PRETT Y PRIRIE KS 67570

Officer/Director/Trustee Three

FARROL BROWN
OFFICER
16514 S OLD STAGE RD
PRETTY PRAIRIE KS 67570

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/28/2015
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E11 - Single Organization Support
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 Yes
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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