FORM 1023-EZ for JOHN BUCK MEMORIAL COMMUNITY FOOD BANK

Field Data
EIN 47-5530863
Case Number EO-2016307-000198
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JOHN BUCK MEMORIAL COMMUNITY FOOD BANK
Organization’s Mailing Address 2028 STATE ROUTE 487
City ORANGEVILLE
State PA
ZIP 17859
Accounting period End 12
Primary contact name KATHY JOHN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KATHY JOHN
PRESIDENT
2643 STATE ROUTE 487
ORANGEVILLE PA 17859

Officer/Director/Trustee Two

STEVE HOFFMAN
VICE-PRESIDENT
14 KNOB MT TERRACE
ORANGEVILLE PA 17859

Officer/Director/Trustee Three

LORI FARVER
SECRETARY
275 FESTER RD
ORANGEVILLE PA 17859

Officer/Director/Trustee Four

ERIKA BURKHART
TREASURER
515 MILLERTOWN RD
BLOOMSBURG PA 17815

Officer/Director/Trustee Five

CHERYL BROBST
BOARD MEMBER
18 EVANS LANE
ORANGEVILLE PA 17859

Organization’s website
Organization’s email JOHNBUCKFB@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/2000
Organization Incorporation State PA
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 Yes
Disaster relief assistance Yes
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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