FORM 1023-EZ for FILLING STATION 56

Field Data
EIN 46-2974546
Case Number EO-2016326-000273
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FILLING STATION 56
Organization’s Mailing Address PO BOX 1393
City BLOUNTSVILLE
State AL
ZIP 35031
Accounting period End 12
Primary contact name DUSTIN FRACHISEUR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEVE HARTMAN
BOARD MEMBER
19 PINE CIRCLE
ONEONTA AL 35121

Officer/Director/Trustee Two

TANYA KENNETH ROSS SMITH
BOARD MEMBER
523 SAWMILL RD
BLOUNTSVILLE AL 35031

Officer/Director/Trustee Three

DEBRA WATKINS
BOARD MEMBER
950 ASHLEY RD
BLOUNTSVILLE AL 35031

Officer/Director/Trustee Four

DUSTIN FRACHISEUR
PRESIDENT/ TREASURER
822 CHAMBERS RD
ARAB AL 35016

Officer/Director/Trustee Five

ANDREA FRACHISEUR
VICE PRESIDENT/ SECRETARY
822 CHAMBERS RD
ARAB AL 35016

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/5/2013
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K34 - Congregate Meals
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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