FORM 1023-EZ for CLINTON J HORNBUCKLE MEMORIAL FOUNDATION

Field Data
EIN 83-1359623
Case Number EO-2018211-000246
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CLINTON J HORNBUCKLE MEMORIAL FOUNDATION
Organization’s Mailing Address 1315 E 1000 NORTH RD
City TAYLORVILLE
State IL
ZIP 62568
Accounting period End 12
Primary contact name PATRICIA HORNBUCKLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICIA HORNBUCKLE
PRESIDENT
1315 E 1000 NORTH RD
TAYLORVILLE IL 62568

Officer/Director/Trustee Two

GREG HORNBUCKLE
TREASURER
1315 E 1000 NORTH RD
TAYLORVILLE IL 62568

Officer/Director/Trustee Three

KATHRYN GRAHAM
SECRETARY
4103 KENNEDY RD
TAYLORVILLE IL 62568

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/5/18
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 PATRICIA HORNBUCKLE
Signature Title PRESIDENT
Signature Date 7/26/18

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