FORM 1023-EZ for MONTGOMERY COUNTY 4-H FOUNDATION INC

Field Data
EIN 20-0743192
Case Number EO-2015009-000318
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MONTGOMERY COUNTY 4-H FOUNDATION INC
Organization’s Mailing Address 410 PETER PAN RD STE B
City INDEPENDENCE
State KS
ZIP 67301-9384
Accounting period End 12
Primary contact name BRIAN SWISHER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RICHARD FELTS
PRESIDENT
3453 CR 4700
LIBERTY KS 67351

Officer/Director/Trustee Two

DEBBIE DAVIS
SECRETARY
2282 CR 4300
COFFEYVILLE KS 67337

Officer/Director/Trustee Three

LYLE SPRINGER
TREASURER
317 N PARK BLVD
INDEPENDENCE KS 67301

Officer/Director/Trustee Four

JERRY HALL
DIRECTOR
5243 CR 3300
INDEPENDENCE KS 67301

Officer/Director/Trustee Five

ELAINE VAN WINKLE
DIRECTOR
101 TYLER BLVD
COFFEYVILLE KS 67337

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/12/2003
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 Yes
One Third Support Gifts No
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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