FORM 1023-EZ for CASEYS FOUNDATION INC
| Field | Data |
|---|---|
| EIN | 47-5441566 |
| Case Number | EO-2016077-000194 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | CASEYS FOUNDATION INC |
| Organization’s Mailing Address | 426 S PALMERS CHAPEL RD |
| City | COTTONTOWN |
| State | TN |
| ZIP | 37048 |
| Accounting period End | 12 |
| Primary contact name | TERESA BUSH |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
Officer/Director/Trustee One
TERESA BUSH
DIRECTOR
426 S PALMERS CHAPEL RD
COTTONTOWN TN 37048-5105
Officer/Director/Trustee Two
MATTHEW BUSH
CHAIRMAN
426 S PALMERS CHAPEL RD
COTTONTOWN TN 37048
Officer/Director/Trustee Three
AMY BRADFORD
SECRETARY/TREASURER
211 STEPHANIE DRIVE
WHITE HOUSE TN 37188
Officer/Director/Trustee Four
CHRISTI WIATT
ASSISTANT DIRECTOR
1861 N ESSEX CIRCLE
MESA AZ 85207-2823
Officer/Director/Trustee Five
LISA SOUTHERS
VICE CHAIRMAN
2606 HERMITAGE PARK DR
HERMITAGE TN 37076-3198
| Organization’s website | WWW.CASEYSFOUNDATION.COM |
|---|---|
| Organization’s email | TCBUSH@CASEYSFOUNDATION.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/21/2015 |
| Organization Incorporation State | TN |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P01 - Alliance/Advocacy Organizations |
| 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 | 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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