FORM 1023-EZ for KIWANIS YOUTH SERVICES INC

Field Data
EIN 81-3642738
Case Number EO-2019253-000192
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KIWANIS YOUTH SERVICES INC
Organization’s Mailing Address 1001 N ELM STREET
City DENTON
State TX
ZIP 76201
Accounting period End 9
Primary contact name SIMONE ROYSTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAMELA BARNES
PRESIDENT
1001 N ELM STREET
DENTON TX 76201

Officer/Director/Trustee Two

ALLEN CHICK
VICE PRESIDENT
1001 N ELM STREET
DENTON TX 76201

Officer/Director/Trustee Three

CRYSTAL WOOD
SECRETARY
1001 N ELM STREET
DENTON TX 76201

Officer/Director/Trustee Four

SIMONE ROYSTER
TREASURER
1001 N ELM STREET
DENTON TX 76201

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/13/16
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SIMONE ROYSTER
Signature Title TREASURER
Signature Date 9/6/19
EIN 81-3642738
Case Number EO-2016239-000205
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KIWANIS YOUTH SERVICES INC
Organization’s Mailing Address 1001 N ELM STREET
City DENTON
State TX
ZIP 76201
Accounting period End 12
Primary contact name SIMONE ROYSTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CYSTAL WOOD
PRESIDENT
1001 N ELM STREET
DENTON TX 76201

Officer/Director/Trustee Two

JOHN MALLOUF
VICE PRESIDENT
1001 N ELM STREET
DENTON TX 76201

Officer/Director/Trustee Three

NANCY MILLICHAMP
SECRETARY
1001 N ELM STREET
DENTON TX 76201

Officer/Director/Trustee Four

SIMONE ROYSTER
TREASURER
604 S ELM STREET
DENTON TX 76201

Officer/Director/Trustee Five

DAVID PICCOLO
BOARD MEMBER
1001 N ELM STREET
DENTON TX 76201

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/13/2016
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
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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