FORM 1023-EZ for ANTWERP FOOD PANTRY INC

Field Data
EIN 81-1763512
Case Number EO-2016124-000118
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ANTWERP FOOD PANTRY INC
Organization’s Mailing Address 45 MAIN STREET
City ANTWERP
State NY
ZIP 13608
Accounting period End 12
Primary contact name DAVE GERRISH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DAVE GERRISH
PRESIDENT
102 MECHANIC ST PO BOX 589
ANTWERP NY 13608

Officer/Director/Trustee Two

KATIE STOFFEL
TREASURER
35 MADISON AVE PO BOX 673
ANTWERP NY 13608

Officer/Director/Trustee Three

ED MONTGOMERY
EXECUTIVE DIRECTOR
27 MAIN ST
ANTWERP NY 13608

Officer/Director/Trustee Four

DANIEL MUNROE
VICE PRESIDENT
319 MAIN ST
ANTWERP NY 13608

Officer/Director/Trustee Five

RHONDA MUNROE
SECRETARY
319 MAIN ST
ANTWERP NY 13608

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/26/2016
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K31 - Food Banks, Food Pantries
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
Signature Title
Signature Date

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