FORM 1023-EZ for ROCK AWAY KIDS CANCER

Field Data
EIN 47-1205031
Case Number EO-2014279-000270
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROCK AWAY KIDS CANCER
Organization’s Mailing Address 13741 W 138TH ST APT 206
City OLATHE
State KS
ZIP 66062
Accounting period End 12
Primary contact name JEANNETTE NIENKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NATALIE FABAC
DIRECTOR
11935 104TH AVE
SEMINOLE FL 33778

Officer/Director/Trustee Two

MANDY GAIL-WOODS
DIRECTOR
18714 ROSEBUD LANE
TOMBALL TX 77377

Officer/Director/Trustee Three

HOLLY BANKER
OFFICER
9 W CRITTENDEN AVE
COVINGTON KY 41011

Officer/Director/Trustee Four

VALERIE JEAN-JONES
OFFICER
848 AMBERJACK LANE
ATLANTA BEACH FL 32233

Officer/Director/Trustee Five

JEANNETTE NIENKE
DIRECTOR
13741 W 138TH ST APT 206
OLATHE KS 66062

Organization’s website HTTP://WWW.ROCKAWAYKIDSCANCER.ORG
Organization’s email ROCKAWAYKIDSCANCER@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/2/2014
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H30 - Cancer Research
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 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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