FORM 1023-EZ for ROSE K BOATWRIGHT FOOD PANTRY INC

Field Data
EIN 85-1542415
Case Number EO-2020195-001024
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROSE K BOATWRIGHT FOOD PANTRY INC
Organization’s Mailing Address 209 BRIDGERS AVE
City AUBURNDALE
State FL
ZIP 33823-3514
Accounting period End 12
Primary contact name ERIC K ALLEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUSAN STOVER
PRESIDENT/TREASURE
1298 42ND ST NW
WINTER HAVEN FL 33881-2265

Officer/Director/Trustee Two

DALLAR BLISS
VICE PRESIDENT
2130 SADDLEWOOD DR
BARTOW FL 33830-2914

Officer/Director/Trustee Three

MARLA HICKS
SECRETARY
4509 S PIPKIN RD
LAKELAND FL 33811-1463

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/22/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SUSAN STOVER
Signature Title PRESIDENT/TREASURE
Signature Date 7/11/2020

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