FORM 1023-EZ for PANTHER BACKPACK

Field Data
EIN 81-1955902
Case Number EO-2016228-000428
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PANTHER BACKPACK
Organization’s Mailing Address 305 NIGHTWIND DRIVE
City MAINEVILLE
State OH
ZIP 45039
Accounting period End 12
Primary contact name SCOTT WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SCOTT WILLIAMS
PRESIDENT
305 NIGHTWIND DRIVE
MAINEVILLE OH 45039

Officer/Director/Trustee Two

MICKEY YOUNG
VICE PRESIDENT
156 CORWIN ROAD
OREGONIA OH 45054

Officer/Director/Trustee Three

MELISSA WILLIAMS
SECRETARY/TREASURER
305 NIGHTWIND DRIVE
MAINEVILLE OH 45039

Officer/Director/Trustee Four

RON CORBIN
BOARD MEMBER
9779 LAUREL GLEN DRIVE
LOVELAND OH 45140

Officer/Director/Trustee Five

PHILLIP BOSTICK
BOARD MEMBER
1241 CHEYENNE COURT
MORROW OH 45152

Organization’s website PANTHERBACKPACK.COM
Organization’s email PANTHERBACKPACK@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/2/2015
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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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