FORM 1023-EZ for COMMUNITY LUNCH LADY FOUNDATION

Field Data
EIN 84-3411264
Case Number EO-2019301-000348
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COMMUNITY LUNCH LADY FOUNDATION
Organization’s Mailing Address 14440 CARLISILE ST
City DETROIT
State MI
ZIP 48205
Accounting period End 12
Primary contact name MONQIUE VANDERGRAFF-WHITE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MONIQUE VANDERGRAFF-WHITE
C.E.O
14440 CARLISLE ST
DETROIT MI 48205

Officer/Director/Trustee Two

GREGORY WHITE
BOARD MEMBER
14440 CARLISLE ST
DETROIT NJ 48205

Officer/Director/Trustee Three

SHANNON SMITH
BOARD MEMBER
43 CLINTON AVE
KEARNY NJ

Officer/Director/Trustee Four

STEVE WILLIAMS
BOARD MEMBER
60 WEST MARGARET ST
DETROIT MI 48203

Officer/Director/Trustee Five

TIARAJAI ROBINSON
BOARD MEMBER
26465 DARTMOUTH ST APT 2
INKSTER MI 48141

Organization’s website
Organization’s email MVANDERGRAFF@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/18/19
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K6D -
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MONIQUE VANDERGRAFF-WHITE
Signature Title C.E.O
Signature Date 10/18/19

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