FORM 1023-EZ for KINGS KOURTZ LLC INC

Field Data
EIN 81-3278154
Case Number EO-2021133-000361
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KINGS KOURTZ LLC INC
Organization’s Mailing Address 53181 GENTLE BREEZE CT
City SOUTH BEND
State IN
ZIP 46628-9080
Accounting period End 12
Primary contact name LATOYA KING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LATOYA KING
PRESIDENT
53181 GENTLE BREEZE CT
SOUTH BEND IN 46628-9080

Officer/Director/Trustee Two

LYNN KING
TREASURER
53181 GENTLE BREEZE CT
SOUTH BEND IN 46628-9080

Officer/Director/Trustee Three

DAVID MOSS
BOARD MEMBER
22057 SANDYBROOK DR
SOUTH BEND IN 46628-9080

Officer/Director/Trustee Four

SARAH TAYLOR
BOARD MEMBER
59699 BLUEBIRD CT
SOUTH BEND IN 46628-9080

Organization’s website
Organization’s email KINGSKOURTZ3@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/12/2017
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 LATOYA KING
Signature Title PRESIDENT
Signature Date 5/11/2021
EIN 81-3278154
Case Number EO-2017170-000158
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KINGS KOURTZ INC
Organization’s Mailing Address 1919 N ELMER ST
City SOUTH BEND
State IN
ZIP 46628
Accounting period End 12
Primary contact name LATOYA KING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LATOYA KING
PRESIDENT
1919 N ELMER ST
SOUTH BEND IN 46628

Officer/Director/Trustee Two

LYNN KING
VICE PRESIDENT, TREASURER
1919 N ELMER ST
SOUTH BEND IN 46628

Officer/Director/Trustee Three

PAM HARRIS
SECRETARY
3814 PALOMINO CIRCLE APT 3B
SOUTH BEND IN 46628

Officer/Director/Trustee Four

RIC MAUCH
BOARD MEMBER
14682 HORSESHOE BEND CT
GRANGER IN 46530

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/12/2017
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O99 - Youth Development N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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
Signature Title
Signature Date

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